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Spinal cord tethering and syringomyelia after trauma: impact of age and surgical outcome
Posttraumatic spinal cord tethering and syringomyelia frequently lead to progressive neurological loss. Although several studies demonstrated favourable outcome following spinal cord detethering with/without shunting, additional research is required as no clear consensus exists over the ideal treatm...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10349820/ https://www.ncbi.nlm.nih.gov/pubmed/37454226 http://dx.doi.org/10.1038/s41598-023-38565-0 |
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author | Bratelj, Denis Stalder, Susanne Capone, Crescenzo Jaszczuk, Phillip Dragalina, Cristian Pötzel, Tobias Gebhard, Catherine Fiechter, Michael |
author_facet | Bratelj, Denis Stalder, Susanne Capone, Crescenzo Jaszczuk, Phillip Dragalina, Cristian Pötzel, Tobias Gebhard, Catherine Fiechter, Michael |
author_sort | Bratelj, Denis |
collection | PubMed |
description | Posttraumatic spinal cord tethering and syringomyelia frequently lead to progressive neurological loss. Although several studies demonstrated favourable outcome following spinal cord detethering with/without shunting, additional research is required as no clear consensus exists over the ideal treatment strategy and knowledge about prognostic demographic determinants is currently limited. In this investigation, we retrospectively investigated 67 patients (56 men, 11 women) who were surgically treated and followed for symptomatic spinal cord tethering and syringomyelia from 2012 to 2022 at our center. Age (B-coefficient 0.396) and severity of trauma to the spinal cord (B-coefficient − 0.462) have been identified as independent predictors for the rate of development of symptomatic spinal cord tethering and syringomyelia (p < 0.001). Following untethering surgery including expansion duraplasty with/without shunting, 65.9% of patients demonstrated an improvement of neurological loss (p < 0.001) whereas 50.0% of patients displayed amelioration of spasticity and/or neuropathic pain (p < 0.001). Conclusively, active screening for symptomatic spinal cord tethering and syringomyelia, particularly in younger patients with severe spinal trauma, is crucial as surgical untethering with/without shunting is able to achieve favourable clinical outcomes. This knowledge may enable clinicians to tailor treatment strategies in spinal cord injury patients suffering from progressive neurological loss towards a more optimal and personalized patient care. |
format | Online Article Text |
id | pubmed-10349820 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-103498202023-07-17 Spinal cord tethering and syringomyelia after trauma: impact of age and surgical outcome Bratelj, Denis Stalder, Susanne Capone, Crescenzo Jaszczuk, Phillip Dragalina, Cristian Pötzel, Tobias Gebhard, Catherine Fiechter, Michael Sci Rep Article Posttraumatic spinal cord tethering and syringomyelia frequently lead to progressive neurological loss. Although several studies demonstrated favourable outcome following spinal cord detethering with/without shunting, additional research is required as no clear consensus exists over the ideal treatment strategy and knowledge about prognostic demographic determinants is currently limited. In this investigation, we retrospectively investigated 67 patients (56 men, 11 women) who were surgically treated and followed for symptomatic spinal cord tethering and syringomyelia from 2012 to 2022 at our center. Age (B-coefficient 0.396) and severity of trauma to the spinal cord (B-coefficient − 0.462) have been identified as independent predictors for the rate of development of symptomatic spinal cord tethering and syringomyelia (p < 0.001). Following untethering surgery including expansion duraplasty with/without shunting, 65.9% of patients demonstrated an improvement of neurological loss (p < 0.001) whereas 50.0% of patients displayed amelioration of spasticity and/or neuropathic pain (p < 0.001). Conclusively, active screening for symptomatic spinal cord tethering and syringomyelia, particularly in younger patients with severe spinal trauma, is crucial as surgical untethering with/without shunting is able to achieve favourable clinical outcomes. This knowledge may enable clinicians to tailor treatment strategies in spinal cord injury patients suffering from progressive neurological loss towards a more optimal and personalized patient care. Nature Publishing Group UK 2023-07-15 /pmc/articles/PMC10349820/ /pubmed/37454226 http://dx.doi.org/10.1038/s41598-023-38565-0 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Bratelj, Denis Stalder, Susanne Capone, Crescenzo Jaszczuk, Phillip Dragalina, Cristian Pötzel, Tobias Gebhard, Catherine Fiechter, Michael Spinal cord tethering and syringomyelia after trauma: impact of age and surgical outcome |
title | Spinal cord tethering and syringomyelia after trauma: impact of age and surgical outcome |
title_full | Spinal cord tethering and syringomyelia after trauma: impact of age and surgical outcome |
title_fullStr | Spinal cord tethering and syringomyelia after trauma: impact of age and surgical outcome |
title_full_unstemmed | Spinal cord tethering and syringomyelia after trauma: impact of age and surgical outcome |
title_short | Spinal cord tethering and syringomyelia after trauma: impact of age and surgical outcome |
title_sort | spinal cord tethering and syringomyelia after trauma: impact of age and surgical outcome |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10349820/ https://www.ncbi.nlm.nih.gov/pubmed/37454226 http://dx.doi.org/10.1038/s41598-023-38565-0 |
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