Electrodiagnostic findings of retethering in children with spinal dysraphism

Purpose Retethering of the cord can occur after the initial untethering surgery. Typical neurological manifestations indicative of cord tethering are often difficult to determine in pediatric patients. Patients who had a primary untethering operation are likely to present with some degree of neurolo...

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Bibliographic Details
Published in:Acta neurochirurgica 2023-04, Vol.165 (4), p.915-925
Main Authors: Shin, Hyun Iee, Wang, Kyu-Chang, Lee, Ji Yeoun, Kim, Kyung Hyun, Shin, Hyung-Ik
Format: Article
Language:English
Subjects:
Child
Congenital defects
Electromyography
Humans
Interventional Radiology
Magnetic Resonance Imaging
Medicine
Medicine & Public Health
Minimally Invasive Surgery
Muscles
Nerve conduction
Neural tube defects
Neural Tube Defects - diagnosis
Neural Tube Defects - surgery
Neurological diseases
Neurology
Neuroradiology
Neurosurgery
Neurosurgical Procedures - methods
Original Article - Pediatric Neurosurgery
Patients
Pediatric Neurosurgery
Pediatrics
Retrospective Studies
Spinal cord
Spinal Cord - surgery
Spinal Dysraphism - diagnosis
Spinal Dysraphism - surgery
Surgical Orthopedics
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Summary:Purpose Retethering of the cord can occur after the initial untethering surgery. Typical neurological manifestations indicative of cord tethering are often difficult to determine in pediatric patients. Patients who had a primary untethering operation are likely to present with some degree of neurological deficits from a previous tethering event, and urodynamic studies (UDSs) and spine images are frequently abnormal. Therefore, more objective tools to detect retethering are needed. This study sought to delineate the characteristics of EDS of retethering, and therefore, could support the diagnosis of retethering. Methods Among 692 subjects who had an untethering operation, data from 93 subjects who had been suspected of retethering clinically were retrospectively extracted. The subjects were divided into two groups, a retethered group, and a non-progression group, according to whether or not surgical interventions had been performed. Two consecutive EDSs, clinical findings, spine magnetic resonance imaging scans, and UDSs before the development of new tethering symptoms were reviewed and compared. Results In the electromyography (EMG) study, the appearance of abnormal spontaneous activity (ASA) in new muscles was prominent in the retethered group ( p  
ISSN:0942-0940
0001-6268
0942-0940
DOI:10.1007/s00701-023-05539-0