Hong Kong Journal of Paediatrics

Volume 8 Number 4, October 2003
Abstract

Untethering of the Tethered Cord with Spina Bifida: Experience in the Prince of Wales Hospital, Hong Kong

XL Zhu, HT Wong, WS Poon, CK Yeung

The outcomes of 40 spina bifida cases undergone untethering surgery in the Prince of Wales Hospital with a mean follow-up of 4.5 years were reviewed. There were 11 cases with lipoma of filum (4 asymptomatic) and 29 cases with lipoma of conus (10 asymptomatic). The surgical complication rate was zero for the filum lipoma group, 17.2% local complication and 3.4% neurological complication for the conus lipoma group. For the long-term outcomes of the asymptomatic patients, all remained asymptomatic except one case. In symptomatic patients with filum lipoma and conus lipoma, the respective long-term outcomes were 29% and 37% improved, 57% and 53% stable and 14% and 11% deteriorated. The results are consistent with current international data. The results strengthen our policy to recommend untethering surgery for all young children with tethered cord and for patients of all ages who are deteriorating neurologically due to tethered cord. For older children who are asymptomatic or with stable neurological deficit, untethering surgery will be an option opened to the parents and patient. (HK J Paediatr (new series) 2003;8:318-321)

Key words : Spina bifida; Spinal dysraphism; Spinal lipoma; Tethered cord



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