Impact of tethered cord release on symptoms of Chiari II malformation in children born with a myelomeningocele
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Vivek A. Mehta & Chetan Bettegowda & Anubhav Amin & Mahmood El-Gassim & George Jallo & Edward S. Ahn
- چاپ و سال / کشور: 2010
Description
spinal cord in exacerbating anatomical findings or symptoms of Chiari II malformation (CIIM) has been debated for decades. Despite the association of Chiari II malformation with myelomeningocele, the impact of tethered cord release on CIIM symptoms in patients has not been explored. Methods A retrospective review of 59 patients born with a myelomeningocele was performed. A total of 92 untethering procedures were performed in which symptoms of CIIM were present in 29 cases. In 57 out of 92 cases, the patients did not have symptoms of CIIM prior to untethering. Six cases were excluded because cervicomedullary decompression was performed prior to untethering. The response of CIIM symptoms, syrinx size, and cerebellar tonsil position were examined before and after spinal cord untethering. Results Forty-four characteristic signs and symptoms of CIIM were present prior to 29 untetherings. Thirty-three of 44 (75%) symptoms improved following spinal cord untethering, though no symptom resolved completely. Syrinx size and cerebellar tonsil position were unchanged following untethering. Conclusion The authors conclude that mild to moderate symptoms of CIIM may respond positively to spinal cord untethering, potentially by normalization cerebrospinal fluid flow dynamics. Symptom improvement occurs despite the lack of radiographic evidence of CIIM resolution.
Childs Nerv Syst (2011) 27:975–978 DOI 10.1007/s00381-010-1294-8 Received: 12 July 2010 / Accepted: 23 September 2010 / Published online: 5 October 2010
