title: Spine-shortening vertebral osteotomy for tethered cord syndrome: report of three cases.
abstract: METHODS
  Retrospective case series.
  
  
  OBJECTIVE
  To review findings from 3 patients who underwent spine-shortening vertebral osteotomy for tethered cord syndrome with a minimum follow-up of 3 years.
  
  
  BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Spine-shortening vertebral osteotomy can be a safe and alternative surgical technique for tethered cord syndrome.
authors.affiliation: Division of Orthopedic Surgery, Department of Neuro and Locomotor Science, Akita University School of Medicine, Akita, Japan. miyakosh@doc.med.akita-u.ac.jp
authors.forename: Naohisa
authors.initials: N
authors.lastname: Miyakoshi
authors.forename: Eiji
authors.initials: E
authors.lastname: Abe
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Suzuki
authors.forename: Tadato
authors.initials: T
authors.lastname: Kido
authors.forename: Mitsuho
authors.initials: M
authors.lastname: Chiba
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Shimada
mesh_terms: D000293:Adolescent; D000328:Adult; D002420:Cauda Equina / Q000002:abnormalities / Q000473:pathology / Q000601:surgery; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D016268:Internal Fixators; D007796:Laminectomy / Q000009:adverse effects / Q000379:methods; D017116:Low Back Pain / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D009436:Neural Tube Defects / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods*; D011128:Polyradiculopathy / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D011859:Radiography; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D013131:Spine / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D055815:Young Adult