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논문 기본 정보

자료유형
학술저널
저자정보
Toshitaka Seki (Hokkaido University Graduate School of Medicine) Kazutoshi Hida (Sapporo Azabu Neurosurgical Hospital) Shunsuke Yano (Sapporo Azabu Neurosurgical Hospital) Kiyohiro Houkin (Department of Neurosurgery Hokkaido University)
저널정보
대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.12 No.3
발행연도
2018.1
수록면
551 - 555 (5page)

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초록· 키워드

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Study Design: A retrospective cohort study. Purpose: To examine the validity of prophylactic surgery for children with tethered cord syndrome (TCS). Overview of Literature: Prophylactic surgery for pediatric patients with TCS remains controversial. Methods: We retrospectively analyzed the surgical outcomes of 14 children (nine boys and five girls) with asymptomatic TCS who were surgically treated at Hokkaido University Hospital between 1989 and 2015. Results: The median age at the time of initial surgery for asymptomatic TCS was 28.6 months (range, 0–66 months). The median final follow-up period was 142 months (range, 7–232 months). Of the 14 children with asymptomatic TCS, 12 had lumbosacral lipoma and two had meningocele. According to the classification of spinal lipoma, two children had dorsal type, four had caudal type, two had transitional type, and four had filar type. There were no children with lipomyelomeningocele. All children were free of neurological symptoms until 94 months after the initial surgery. Subsequently, one child exhibited delayed neurological deficits and underwent a second surgery because of motor and sensory disturbances; slight sensory disturbance was noted at the final follow-up examination. Another child later showed bowel and bladder dysfunction. However, a second surgery was not performed for this child because his motor and sensory functions were normal; hence, we chose to avoid nerve injury in the case of dissecting adhesion. Conclusions: All 14 children with asymptomatic TCS were free of neurological symptoms until 94 months after the initial surgery. However, two children exhibited delayed neurological deficits at 94 months and 177 months. We believe that prophylactic surgery for asymptomatic TCS is effective for a certain period. However, because the natural history of TCS is poorly understood, strict follow-up after surgery is necessary.

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참고문헌 (10)

참고문헌 신청
Izci Y / 2011 / Composite type of split cord malformation: rare and difficult to explain / Pediatr Neurosurg 47:461 Crossref Selcuki M / 2000 / Patients with urinary incontinence often benefit from surgical detethering of tight filum terminale / Childs Nerv Syst 16:150~154 Crossref Kulkarni AV / 2004 / Conservative management of asymptomatic spinal lipomas of the conus / Neurosurgery 54:868~873 Crossref Talamonti G / 2014 / Asymptomatic lipomas of the medullary conus: surgical treatment versus conservative management / J Neurosurg Pediatr 14:245~254 Crossref Wykes V / 2012 / Asymptomatic lumbosacral lipomas: a natural history study / Childs Nerv Syst 28:1731~1739 Crossref

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