Spine-shortening vertebral osteotomy for tethered cord syndrome: report of three cases.
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.
Miyakoshi
Naohisa
N
Division of Orthopedic Surgery, Department of Neuro and Locomotor Science, Akita University School of Medicine, Akita, Japan. miyakosh@doc.med.akita-u.ac.jp
Abe
Eiji
E
Suzuki
Tetsuya
T
Kido
Tadato
T
Chiba
Mitsuho
M
Shimada
Yoichi
Y
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