The effect of tethered cord release on scoliosis in myelomeningocele.
J Pediatr Orthop 2000;
20:362-5. [PMID:
10823605]
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Abstract
To understand better the effects of detethering on scoliosis in persons with myelomeningocele, 21 patients with spinal dysraphism and scoliosis who had undergone a detethering procedure were retrospectively reviewed. Fourteen girls and seven boys were followed for an average of 5 years (range, 2-10). Three patients had thoracic, 12 had lumbar, and six had sacral level myelomeningocele. Three patients (14%) had curves that improved, and six (29%) stabilized. Twelve patients (57%) progressed >10 degrees. Eighty-six percent of patients with initial curves of >40 degrees and 100% of thoracic level patients went on to require spinal fusion. Eight complications occurred in six patients. Although patients with curves <40 degrees may have some improvement after a detethering procedure, those presenting with curves >40 degrees or thoracic neurologic levels had no improvement in their scoliosis.
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