Retethering risk in pediatric spinal lipoma of the conus medullaris
| العنوان: | Retethering risk in pediatric spinal lipoma of the conus medullaris |
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| المؤلفون: | Reizo Shirane, Toshiaki Hayashi, Tomomi Kimiwada, Teiji Tominaga |
| المصدر: | Journal of Neurosurgery: Pediatrics. 29:342-349 |
| بيانات النشر: | Journal of Neurosurgery Publishing Group (JNSPG), 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | medicine.medical_specialty, Univariate analysis, Cord, business.industry, General Medicine, Lipoma, medicine.disease, Surgery, Conus medullaris, medicine.anatomical_structure, Spinal lipoma, Patient age, Radiological weapon, medicine, business, Prospective cohort study |
| الوصف: | OBJECTIVE Lipoma of the conus medullaris (LCM) causes neurological symptoms known as tethered cord syndrome (TCS). The symptoms can be seen at diagnosis and during long-term follow-up. In this report, pediatric patients with LCMs who underwent untethering surgery, under the policy of performing surgery if diagnosed regardless of symptoms, were retrospectively reviewed to evaluate long-term surgical outcomes. Possible risk factors for retethered cord syndrome (ReTCS) were evaluated in the long-term follow-up period. METHODS A total of 51 consecutive pediatric patients with LCMs who underwent a first untethering surgery and were followed for > 100 months were retrospectively analyzed. The surgery was performed with the partial removal technique. Pre- and postoperative clinical and radiological data were reviewed to analyze the outcomes of surgery and identify potential risk factors for ReTCS. RESULTS During follow-up, 12 patients experienced neurological deterioration due to ReTCS. The overall 10-year and 15-year progression-free survival rates were 82.3% and 75.1%, respectively. On univariate analysis, a lipoma type of lipomyelomeningocele (OR 11, 95% CI 2.50–48.4; p = 0.0014), patient age at the time of surgery (OR 0.41, 95% CI 0.14–1.18; p = 0.0070), and the mean patient growth rate after surgery (OR 2.00, 95% CI 1.12–3.41; p = 0.0040) were significant factors associated with ReTCS. Cox proportional hazard models showed that a lipoma type of lipomyelomeningocele (HR 5.16, 95% CI 1.54–20.1; p = 0.010) and the mean growth rate after surgery (HR 1.88, 95% CI 1.00–3.50; p = 0.040) were significantly associated with the occurrence of ReTCS. CONCLUSIONS More complex lesions and a high patient growth rate after surgery seemed to indicate increased risk of ReTCS. Larger prospective studies and registries are needed to define the risks of ReTCS more adequately. |
| تدمد: | 1933-0715 1933-0707 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2e0e84af596bda2f26aee0a3c8fc8120Test https://doi.org/10.3171/2021.9.peds21413Test |
| رقم الانضمام: | edsair.doi.dedup.....2e0e84af596bda2f26aee0a3c8fc8120 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19330715 19330707 |
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