Analysis Of Cases Operated With Open Spinal Dysraphism Diagnosis And Undergoing Additional Operation Due To Tensioned Spinal Cord Syndrome Developing In Their Follow-Ups

Research Article

Abstract

Objective: The study was designed to elaborate on additional surgical needs, compare the morbidity and mortality of patients diagnosed with open spinal dysraphism, and statistically analyze the results obtained, thus concretizing both our and the families' expectations and predictions.

Method: This retrospective analysis examined open spinal dysraphism patients who underwent additional surgical intervention due to tethered cord syndrome that developed during their follow-up, as well as all the cases that were operated on due to closed spinal dysraphism during the same years. In total, 96 cases diagnosed with open spinal dysraphism and 42 cases diagnosed with closed spinal dysraphism were included in the study.

Results: Paraparesis was detected at 21.9% in the open group and 2.4% in the closed group. Paraplegia was found at 45.8% in the open group but not in the closed group. Monoparesis was seen at 4.2% in the open group and 19.0% in the closed group. In addition, when the open spinal dysraphism cases were examined within themselves, those who underwent additional TCS surgery had a higher rate of normal neurological examination (29.1%). In comparison, paraplegia was detected at a higher rate in those who did not undergo additional TCS surgery (68.3%). In addition, it was observed that hydrocephalus, shunt requirement, Chiari Malformation, scoliosis/kyphosis presence, urological problems, gastrointestinal problems, and mortality rates were higher in open spinal dysraphism cases (p<0.001).

Conclusion: These findings highlight the need for careful follow-up evaluation of patients with open spinal dysraphism and establishing precise long-term follow-up strategies post-surgery.