Surgical treatment of posttraumatic cystic and tethered spinal cords

Scott P. Falci, Daniel P. Lammertse, Lavar Best, Charlotte A. Starnes, Erin C. Prenger, Anthony T. Stavros, Dave Mellick

Research output: Contribution to journalArticlepeer-review

34 Scopus citations

Abstract

Posttraumatic syringomyelia as a cause of progressive neurologic deterioration has been well described. More recently, the noncystic posttraumatic tethered cord has been associated with identical progressive neurologic deterioration. A retrospective analysis of patients treated surgically with spinal cord untethering and/or cyst shunting to arrest a progressive myelopathy from a posttraumatic tethered and/or cystic cord was performed. Emphasis was on outcome using the American Spinal Injury Association (ASIA) sensory and motor scoring systems. During an 18-month period from May 1993 to December 1994, 70 patients with spinal cord injury were operated upon for tethered and/or cystic spinal cords because of a progressive myelopathy and deteriorating ASIA sensory/motor scores. Fifty-nine patients had follow-up data 1 year postoperatively. At the 1 year follow-up, there was small improvement in light touch sensory scores (0.67 points), pinprick scores (1.3 points), and motor scores (0.41 points) demonstrating that the progression of the myelopathic process was arrested. Thirty-four of these 59 patients had no previous surgery to their spinal cords. At 1 year follow-up, light touch scores improved on average 2.38 points, pinprick scores 3.88 points (p < 0.05), and motor scores 1.47 points, suggesting better outcome with first-time surgery. Of this latter group, 64.3% regained a lost function, 62.5% saw improvement in spasticity, 55.6% had substantial improvement in neurogenic pain, and 95.8% felt that surgery prevented further neurologic deterioration.

Original languageEnglish (US)
Pages (from-to)173-181
Number of pages9
JournalJournal of Spinal Cord Medicine
Volume22
Issue number3
DOIs
StatePublished - Jan 1 1999
Externally publishedYes

Keywords

  • Cyst
  • Posttraumatic
  • Syringomyelia
  • Tethered cord
  • Tethering

ASJC Scopus subject areas

  • Clinical Neurology

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