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Titolo:
CONGENITAL TETHERED SPINAL-CORD SYNDROME IN ADULTS
Autore:
ISKANDAR BJ; FULMER BB; HADLEY MN; OAKES WJ;
Indirizzi:
CHILDRENS HOSP,DIV PEDIAT NEUROSURG,1600 7TH AVE S BIRMINGHAM AL 35233 CHILDRENS HOSP,DIV PEDIAT NEUROSURG BIRMINGHAM AL 35233 UNIV ALABAMA,DEPT NEUROSURG BIRMINGHAM AL 00000
Titolo Testata:
Journal of neurosurgery
fascicolo: 6, volume: 88, anno: 1998,
pagine: 958 - 961
SICI:
0022-3085(1998)88:6<958:CTSSIA>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
BLADDER DYSFUNCTION; DYSRAPHISM; DIASTEMATOMYELIA; DIAGNOSIS;
Keywords:
TETHERED SPINAL CORD; SPINA BIFIDA; OCCULT SPINAL DYSRAPHISM; CONGENITAL ANOMALY; ADULT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
18
Recensione:
Indirizzi per estratti:
Citazione:
B.J. Iskandar et al., "CONGENITAL TETHERED SPINAL-CORD SYNDROME IN ADULTS", Journal of neurosurgery, 88(6), 1998, pp. 958-961

Abstract

Object. The management of tethered spinal cord syndrome with onset ofsymptomatology occurring in adulthood remains controversial, althoughthe necessity of early surgery in the pediatric tethered cord syndrome population is well established. To ascertain the results of surgery in adult patients with this anomaly, the authors undertook a retrospective review of 34 cases. Methods. The authors studied the hospital records of 34 consecutive patients who presented in adulthood with tethered cord syndrome and conducted follow-up phone interviews with 28 of them. The population consisted of 12 men and 22 women, ranging in age from 18 to 70 years (mean 34 years). The most common presenting featurewas pain, followed by weakness and incontinence. All patients underwent surgery. The most common operative findings were tight filum terminale, split cord malformation, and lipomyelomeningocele, paralleling those observed in pediatric studies. Long-term surgical results and patient outcome ratings were encouraging. After a mean clinical follow-up period of 4 years, significant improvement occurred in 22 of 27 patients presenting with pain, 13 of 27 patients with motor or sensory dysfunction, and 11 of 18 patients with bowel and bladder disturbance. In addition, telephone interviews were obtained after a period of 8.6 years. Twenty-two (79%) of 28 patients called the operation a long-term success; 21 (75%) of 28 patients believed that they had significant postoperative improvement land not just stabilization)in pain and/or neurological function. Surgical complications were generally minor. Nineteen (86%) of 22 employed patients returned to work after surgery. Two (33%) of six patients who were not employed before surgery worked full time postoperatively. Only two of the 28 patients interviewed had received Workers' Compensation benefits; both of these had good outcomes and returned to work. Conclusions. Tethered spinal cord syndrome in adults is an uncommon entity that can become symptomatic. Although surgeryin adults involves greater risk of neurological injury than in children, it is a low-risk procedure with encouraging results. Because neurological deficits are generally irreversible, early surgery is recommended.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/09/20 alle ore 18:41:21