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April2013 Vol.50 Issue:        2        Table of Contents
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Early Clinical Characteristics and Surgical Outcome in 10 Children with Occult Spinal Dysraphism

Ayman Elsayed Galhom1, Walid Al-Deeb2, Ahmed Osama2

Departments of Neurosurgery1, Neurology2; Suez Canal University; Egypt

Departments of Neurosurgery1, Neurology2; Suez Canal University; Egypt

 

 



ABSTRACT

Background: Since occult spinal dysraphism can lead to irreversible neurological complications, early diagnosis and treatment are necessary. Objective: To evaluate the clinical and urodynamic outcome after cord release of children with spinal dysraphism with primary tethered cord syndrome. Methods: From January 2006 to January 2011, 10 children with occult spinal dysraphism were referred to the department of neurosurgery, Suez Canal University Hospital. Pre-operative clinical data, Urodynamic tests, somatosensory evoked potential (SSEP) and MRI findings were assessed for all the patients. Operative and post-operative follow up and complications were reported. Results: Seven females and 3 males were included in the study. Their age ranged from 1 month to 7 years. All the patients had normal neurological examination except one had distal weakness. Five patients had urinary incontinence failed on medical treatment and urodynamic tests revealed hyperreflexia. Three patients had evidence of delayed or block at posterior tibial nerve on SSEP. Untethering was performed for all the patients with complete removal of tethering element except two patients with lipoma. Complications were limited and improved with time. The mean follow-up period ranged from 6 months to 4 years. During the follow-up, 7 patients (70%) were improved, 3 patients (30%) had unchanged symptoms and no one (0%) had recurrence of tethering. Conclusion: Early recognition of symptoms and signs of tethering of the spinal cord is crucial in diagnosis and prognosis of spinal dysraphism. Early surgical release of the tethering elements is important for recovery and avoidance of retethering. [Egypt J Neurol Psychiat Neurosurg.  2013; 50(2): 127-134]

Key Words: Occult spinal dysraphism, Tethered cord, urodynamic, Somato-sensory evoked potential.

Correspondence to  Ayman E. Galhom. Department of Neurosurgery, Suez Canal University, Egypt. Email: aiman2gm@hotmail.com





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