Objective. Aim oJ the study is to evaluate what symptoms suggest Tethered Cord Syndrome (TCS) in children affected by myelomeningocele (MMC) and what are the diagnostic strategies for a correct surgical timing. Methods. The study consists in a retrospective evaluation of 22 MMC patients' clinical history after surgical spinal detethering, performed between 1991 and 2008. Every patient was monitored according to a clinical-diagnostic protocol used in the Department oJ Pediatrics of the University of Padua. Results. Signs and symptoms suggesting TCS presented Jrequently in this population were: motor (77%), spinal curves variations such as scoliosis (63,6%), Chiari Malformation symptoms (45%), sphinteric (40,9%), urodynamical study changes (50%, in an hali of them without clinical symptoms), sensitive (40,9%). Globally, after surgical detetherig, we observe a worsening in 2 children (9%), while 16 patients improve (73%). Only 4 children (18%) tend to be clinically stable. Conclusions. As in MMC patients life expectancy grows, TCS diagnosis becomes more importantJor the difficulty to detect the subtle and slow neurological and/or sphinterical worsening also in these so compromised patients. We confirm the fundamental rale oJ a multidisciplinary follow up for the prevention and the precocious diagnosis of TCS.

Tethered Cord Sindrome nel mielomeningocele: follow up per un timing diagnostico-terapeutico

GATTA, MICHELA;DRIGO, PAOLA
2009

Abstract

Objective. Aim oJ the study is to evaluate what symptoms suggest Tethered Cord Syndrome (TCS) in children affected by myelomeningocele (MMC) and what are the diagnostic strategies for a correct surgical timing. Methods. The study consists in a retrospective evaluation of 22 MMC patients' clinical history after surgical spinal detethering, performed between 1991 and 2008. Every patient was monitored according to a clinical-diagnostic protocol used in the Department oJ Pediatrics of the University of Padua. Results. Signs and symptoms suggesting TCS presented Jrequently in this population were: motor (77%), spinal curves variations such as scoliosis (63,6%), Chiari Malformation symptoms (45%), sphinteric (40,9%), urodynamical study changes (50%, in an hali of them without clinical symptoms), sensitive (40,9%). Globally, after surgical detetherig, we observe a worsening in 2 children (9%), while 16 patients improve (73%). Only 4 children (18%) tend to be clinically stable. Conclusions. As in MMC patients life expectancy grows, TCS diagnosis becomes more importantJor the difficulty to detect the subtle and slow neurological and/or sphinterical worsening also in these so compromised patients. We confirm the fundamental rale oJ a multidisciplinary follow up for the prevention and the precocious diagnosis of TCS.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11577/2456071
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