Secondary Logo

Journal Logo

The Effect of Tethered Cord Release on Scoliosis in Tight Filum Terminale: E‐Poster #34

Jea, Andrew MD (Texas Children's Hospital, Baylor College of Medicine); Chern, Joshua J. MD, PhD; Dauser, Robert C. MD; Whitehead, William E. MD; Curry, Daniel J. MD; Luerssen, Thomas G. MD

Spine Journal Meeting Abstracts: September 2009 - Volume 10 - Issue - p 178
  • Free

Introduction: The association between neuromuscular scoliosis and tethered spinal cord has been well‐documented, and most of these studies were based on patients with myelomeningocele. There have not been studies examining the effects of spinal cord untethering on scoliosis in children with tight filum terminale.

Methods: 45 pediatric patients with tight filum terminale who had undergone untethering were retrospectively reviewed to understand the effects of untethering on scoliosis progression

Results: 26 girls and 19 boys underwent tethered cord release at a mean age of 4.5 years. 14 of 45 (31%) patients presented with scoliosis. 5 patients had thoracic scoliosis, 7 had thoracolumbar scoliosis, and 2 had lumbar scoliosis. After untethering surgery (mean follow‐up of 28 months), 7 curves progressed > 10 degrees (5 patients eventually underwent surgical fusion). 2 patients had curves that improved, and 5 stabilized. In the group of 31 patients without scoliosis on presentation, 2 patients developed de novo scoliosis > 10 degrees during the follow‐up period. Therefore, at the end of follow‐up period, 36 of 45 patients (80%) had stable or improved spinal alignment, while 9 of 45 patients (20%) progressed. In the multivariate analysis, patients who presented with a Cobb angle greater than 35 degrees were most likely to progress (p=0.002, OR=21). There was no operative morbidity or mortality associated with scoliosis surgery.

Conclusion: A significant number of children with tight filum terminale were found to have scoliosis in agreement with the literature. Tethered cord release may not stabilize scoliosis in a substantial number of these patients. Most patients with progressive curves needed scoliosis correction and spinal fusion.

Significance: A significant number of children with tight filum terminale were found to have scoliosis in agreement with the literature. Tethered cord release may not stabilize scoliosis in a substantial number of these patients. Most patients with progressive curves needed scoliosis correction and spinal fusion.

© 2009 Lippincott Williams & Wilkins, Inc.