DIAGNOSTIC CRITERIA FOR SURGICAL TREATMENT OF TETHERED CORD SYNDROME: A LITERATURE REVIE
Keywords:
children, spina bifida, spinal cord, tethered cord syndromeAbstract
Objective: To analyze the literature on diagnostic criteria for tethered cord syndrome and to determine indications for surgical treatment.
Materials and Methods: An extensive search was performed to identify prospective cohort clinical studies published from 2010 to 2024 in the PubMed, EMBASE, eLibrary, and Cochrane Library databases. The research adhered to the PRISMA international guidelines for meta-analysis reporting, with evidence levels and recommendation strength evaluated following the ASSO protocol.
Results: 260 literature sources were found in the databases. Duplicate materials (n = 41) were removed. After excluding full-text articles, 118 studies remained, but only 18 met the inclusion criteria and were analyzed. In terms of evidence level, 13 studies were classified as level B, and 5 as level C.
Conclusion: The components of tethered cord syndrome include a dystopic spinal cord cone, a shortened fixed terminal filum, and the presence of a lumbosacral lipoma. However, clear criteria for an integrated assessment of the clinical, morphological, and functional status of patients are currently lacking, and existing scales are not specific. The described MRI criteria have a limited level of evidence for determining indications for surgical spinal cord tethering. The absence of clear indications for surgery and the disputability of performing prophylactic spinal cord defixation require further study of the problem with a focus on analyzing the criteria for spinal cord tension syndrome.
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