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Journal of Indian Association of Pediatric Surgeons
     Journal of Indian Association of Pediatric Surgeons
Official journal of the Indian Association of Pediatric Surgeons         
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Year : 2019  |  Volume : 24  |  Issue : 2  |  Page : 124-128

Tethered cord syndrome-role of early surgery

Department of Paediatric Surgery, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India

Correspondence Address:
Dr. Anand Alladi
Department of Paediatric Surgery, Bangalore Medical College and Research Institute Super Speciality Hospital, Victoria Hospital Campus, Fort, Bengaluru - 560 002, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jiaps.JIAPS_49_18

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Purpose: 1. To evaluate the clinical course and effects of surgery on preexisting neurodeficits. 2. To address the issue of timing of intervention. Materials: A prospective study at department of pediatric surgery, Bangalore Medical College and Research Institute and other hospitals from 2013 to 2017. Results: There were 44 patients. Over 3/4 presented with a cutaneous marker while 9 had deficits and no markers. The commonest marker was a swelling on the back. 1/3 of infants had neurological sequelae while almost all midline older children presented with bowel/bladder/gait disturbances. All underwent detethering. Post-operative complications were minor and self-limiting. None of the children had associated Chiari malformation and 2 had a syrinx which at last follow up has been static and shown no clinical signs. Recovery was mostly seen in infants and only in one older child. Conclusion: Most of the patients with lipomeningomyelocele have early onset deficits and is recommended to operate at diagnosis. Children presenting with only deficits need to be evaluated for tethered cord syndrome but generally show poor or no recovery of deficits. Early prophylactic detethering is safe, feasible and advisable.


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