Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 Mar;30(3):599-611.
doi: 10.1007/s00586-020-06662-7. Epub 2020 Nov 17.

Is detethering necessary before deformity correction in congenital scoliosis associated with tethered cord syndrome: a meta-analysis of current evidence

Kaustubh Ahuja  1 , Syed Ifthekar  1 , Samarth Mittal  1 , Gagandeep Yadav  1 , P Venkata Sudhakar  1 , Sitanshu Barik  1 , Pankaj Kandwal  2
Affiliations
Meta-Analysis

Is detethering necessary before deformity correction in congenital scoliosis associated with tethered cord syndrome: a meta-analysis of current evidence

Kaustubh Ahuja et al. Eur Spine J. 2021 Mar.

Abstract

Purpose: To compare the clinical and radiological outcomes in patients with congenital scoliosis (CS) and tethered cord syndrome (TCS) undergoing deformity correction with (NI group) versus without (NNI group) prior neurosurgical intervention aimed at detethering the cord.

Methods: A systematic review and meta-analysis were performed. The databases PubMed, Embase and Google Scholar were searched until March 2020. Inclusion criteria was studied describing performance of deformity correction and fusion surgery for congenital scoliosis with tethered cord syndrome with or without prior detethering procedure. Studies describing growth sparing procedures or congenital scoliosis associated with non-tethering pathologies such as syrinx were excluded. Case reports and series with less than 10 subjects were also excluded. NIH quality assessment tool was used for assessing quality of individual study.

Results: Sixteen studies were included for analysis of which eight were found to be retrospective case series (level IV evidence) and retrospective case-control studies (level III evidence) each. Overall proportional meta-analysis found no significant difference in correction rate, operative duration, blood loss or complication rate between the NI and NNI groups. However, subgroup analysis performed after inclusion of only level III evidence studies revealed significantly lesser operative duration and blood loss with comparable correction and complication rate in NNI group.

Conclusion: Deformity correction and fusion surgery may be performed safely and effectively in CS with TCS patients without the need of a prior detethering procedure.

Keywords: Congenital scoliosis; Detethering; Intraspinal anomalies; Neurological complications; Surgical outcomes.

PubMed Disclaimer

Comment in

References

    1. Basu PS, Elsebaie H, Noordeen MHH (2002) Congenital spinal deformity: a comprehensive assessment at presentation. Spine 27:2255–2259. https://doi.org/10.1097/00007632-200210150-00014 - DOI - PubMed
    1. Shen J, Wang Z, Liu J et al (2013) Abnormalities associated with congenital scoliosis: a retrospective study of 226 Chinese surgical cases. Spine 8:814–818. https://doi.org/10.1097/BRS.0b013e31827ed125 - DOI
    1. Kokubun S, Ozawa H, Aizawa T et al (2011) Spine-shortening osteotomy for patients with tethered cord syndrome caused by lipomyelomeningocele. J Neurosurg Spine 15:21–27. https://doi.org/10.3171/2011.2.SPINE10114 - DOI - PubMed
    1. Hedequist D, Emans J (2007) Congenital scoliosis: a review and update. J Pediatr Orthop 27:106–116. https://doi.org/10.1097/BPO.0b013e31802b4993 - DOI - PubMed
    1. Jayaswal A, Kandwal P, Goswami A et al (2016) Early onset scoliosis with intraspinal anomalies: management with growing rod. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 25:3301–3307. https://doi.org/10.1007/s00586-016-4566-5 - DOI

LinkOut - more resources