title: Tethered cord: natural history, surgical outcome and risk for Chiari malformation 1 (CM1): a review of 110 detethering.
abstract: The surgical results of this series of occult spina bifida seem better than the natural history registered in the long pre-operative period in terms of neurological deterioration. The major contribution to this result is attributed to neurophysiological monitoring that lowers the risks of permanent damage and increases the percentage of effective detethering. The present series of TCS, due to conus and filar lipoma, documents that CM1 is a really rare association occurring in less than 6% of the patients, despite the low position of conus. The detethering procedure did not influence the tonsillar position, thus excluding the correlation between the tethering and the tonsillar descent. The genetic alteration documented in a girl reinforces the hypothesis of a rare complex polymaformative picture deserving multiple procedures according to the prevailing clinical symptoms.
authors.affiliation: Department of Neurosurgery, Fondazione Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy. lvalentini@istituto-besta.it
authors.forename: Laura Grazia
authors.initials: LG
authors.lastname: Valentini
authors.forename: Giorgio
authors.initials: G
authors.lastname: Selvaggio
authors.forename: Sergio
authors.initials: S
authors.lastname: Visintini
authors.forename: Alessandra
authors.initials: A
authors.lastname: Erbetta
authors.forename: Vidmer
authors.initials: V
authors.lastname: Scaioli
authors.forename: Carlo Lazzaro
authors.initials: CL
authors.lastname: Solero
mesh_terms: D001139:Arnold-Chiari Malformation / Q000209:etiology* / Q000601:surgery; D002675:Child, Preschool; D004576:Electromyography; D005260:Female; D006801:Humans; D007558:Italy; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D009436:Neural Tube Defects / Q000601:surgery; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000503:physiopathology*; D012189:Retrospective Studies; D016136:Spina Bifida Occulta / Q000601:surgery