Spine-shortening vertebral osteotomy for tethered cord syndrome: report of three cases

• Published in: Spine (Philadelphia, Pa. 1976) Pa. 1976), 2009-10, Vol.34 (22), p.E823-E825
• Main Authors: Miyakoshi, Naohisa, Abe, Eiji, Suzuki, Tetsuya, Kido, Tadato, Chiba, Mitsuho, Shimada, Yoichi
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Cauda Equina - abnormalities; Cauda Equina - pathology; Cauda Equina - surgery; Female; Gait Disorders, Neurologic - etiology; Gait Disorders, Neurologic - physiopathology; Gait Disorders, Neurologic - surgery; Humans; Internal Fixators; Laminectomy - adverse effects; Laminectomy - methods; Low Back Pain - etiology; Low Back Pain - physiopathology; Low Back Pain - surgery; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - pathology; Lumbar Vertebrae - surgery; Magnetic Resonance Imaging; Male; Neural Tube Defects - diagnostic imaging; Neural Tube Defects - pathology; Neural Tube Defects - surgery; Neurosurgical Procedures - adverse effects; Neurosurgical Procedures - methods; Osteotomy - instrumentation; Osteotomy - methods; Polyradiculopathy - etiology; Polyradiculopathy - physiopathology; Polyradiculopathy - surgery; Postoperative Complications - etiology; Postoperative Complications - physiopathology; Postoperative Complications - prevention & control; Radiography; Spinal Fusion - instrumentation; Spinal Fusion - methods; Spine - diagnostic imaging; Spine - pathology; Spine - surgery; Thoracic Vertebrae - diagnostic imaging; Thoracic Vertebrae - pathology; Thoracic Vertebrae - surgery; Treatment Outcome; Urinary Bladder, Neurogenic - etiology; Urinary Bladder, Neurogenic - physiopathology; Urinary Bladder, Neurogenic - surgery; Young Adult
• ISSN: 0362-2436; 1528-1159
• DOI: 10.1097/BRS.0b013e3181af2607

Retrospective case series. To review findings from 3 patients who underwent spine-shortening vertebral osteotomy for tethered cord syndrome with a minimum follow-up of 3 years. Surgical detethering is the gold standard for symptomatic tethered cord syndrome. However, complications such as cerebrospinal fluid leakage and neurologic deterioration are common. Spine-shortening vertebral osteotomy, proposed by Kokubun, is an alternative surgical technique to reduce neural tension indirectly. However, case series of this novel procedure for tethered cord syndrome have not been reported in the English literature. Three patients aged 13, 22, and 27 years presented with progressive pain and/or neurologic dysfunction. They underwent spine-shortening vertebral osteotomy of L1 with a pedicle screw and rod system. Their clinical and radiologic outcomes are reviewed. All patients got relief from their preoperative symptoms after surgery, and no complications occurred. Complete bone union was obtained in all patients without correction loss. Spine-shortening vertebral osteotomy can be a safe and alternative surgical technique for tethered cord syndrome.