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New Spinal Shortening Technique for Tethered Cord Syndrome: A Technical Note – Lumbar Spinal Stenosis

The article discusses a new spinal shortening technique for treating tethered cord syndrome (TCS), a condition that causes progressive neurological decline. While surgical detethering is the standard treatment for TCS, it can result in retethering in a significant number of patients. To address this issue, a posterior spinal shortening osteotomy technique has been used, but it carries risks of blood loss and neurological deterioration. The authors present a new safe spinal shortening technique for TCS, which was successfully performed on a 31-year-old patient with gait disturbance. The surgery involved disectomy and Ponte osteotomy to shorten the spinal column, resulting in the release of tension on the spinal cord. The patient showed significant improvement in muscle testing and sensory function after one year of follow-up. This new technique offers an alternative option for treating retethered spinal cord in patients with TCS

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : innovative spine facility in UK

Published article

Background and Objectives: To present a new spinal shortening technique for tethered cord syndrome. Tethered cord syndrome (TCS) is a debilitating condition leading to progressive neurological decline. Surgical detethering for TCS is the gold standard of treatment. However, symptomatic retethering of TCS has been reported in 5%-50% of patients after initial release. To solve this problem, posterior spinal shortening osteotomy has been reported. This technique has risks of massive blood loss and…

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Medicina (Kaunas). 2023 Dec 22;60(1):20. doi: 10.3390/medicina60010020.ABSTRACTBackground and Objectives: To present a new spinal shortening technique for tethered cord syndrome. Tethered cord syndrome (TCS) is a debilitating condition leading to progressive neurological decline. Surgical detethering for TCS is the gold standard of treatment. However, symptomatic retethering of TCS has been reported in 5%-50% of patients,

Medicina (Kaunas). 2023 Dec 22;60(1):20. doi: 10.3390/medicina60010020.

ABSTRACT

Background and Objectives: To present a new spinal shortening technique for tethered cord syndrome. Tethered cord syndrome (TCS) is a debilitating condition leading to progressive neurological decline. Surgical detethering for TCS is the gold standard of treatment. However, symptomatic retethering of TCS has been reported in 5%-50% of patients after initial release. To solve this problem, posterior spinal shortening osteotomy has been reported. This technique has risks of massive blood loss and neurological deterioration. The authors hereby report a new safe spinal shortening technique for tethered cord syndrome. Materials and Methods: A 31-year-old man with gait disturbance was referred to our hospital. After the delivery of treatment, he underwent surgical untethering of the spinal cord in another hospital. He had hyperreflexia of the Achilles tendon reflex and bilateral muscle weakness of the legs (MMT 3-4). He also had urinary and bowel incontinence, and total sensory loss below L5. An anteroposterior lumbar radiogram indicated partial laminectomy of L3 and L4. Lumbar MRI showed retethering of spinal cord. Results: The patient underwent a new spinal shortening technique for tethered cord syndrome under the guidance of O-arm navigation. First, from the anterior approach, disectomy from T12 to L3 was performed. Second, from the posterior approach, Ponte osteotomy was performed from T12 to L3, shortening the spinal column by 15 mm. The patient was successfully treated surgically. Postoperative lumbar MRI showed that the tension of the spinal cord was released. Manual muscle testing results and the sensory function of the left leg had recovered almost fully upon final follow-up at one year. Conclusions: A retethered spinal cord after initial untethering is difficult to treat. This new spinal shortening technique can represent another good option to release the tension of the spinal cord.

PMID:38256281 | DOI:10.3390/medicina60010020

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New Spinal Shortening Technique for Tethered Cord Syndrome: A Technical Note

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Medicina (Kaunas). 2023 Dec 22;60(1):20. doi: 10.3390/medicina60010020.ABSTRACTBackground and Objectives: To present a new spinal shortening technique for tethered cord syndrome. Tethered cord syndrome (TCS) is a debilitating condition leading to progressive neurological decline. Surgical detethering for TCS is the gold standard of treatment. However, symptomatic retethering of TCS has been reported in 5%-50% of patients

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