The effect of tethered cord release on scoliosis in myelomeningocele.

Abstract

To understand better the effects of detethering on scoliosis in persons with myelomeningocele, 21 patients with spinal dysraphism and scoliosis who had undergone a detethering procedure were retrospectively reviewed. Fourteen girls and seven boys were followed for an average of 5 years (range, 2-10). Three patients had thoracic, 12 had lumbar, and six had sacral level myelomeningocele. Three patients (14%) had curves that improved, and six (29%) stabilized. Twelve patients (57%) progressed >10 degrees. Eighty-six percent of patients with initial curves of >40 degrees and 100% of thoracic level patients went on to require spinal fusion. Eight complications occurred in six patients. Although patients with curves <40 degrees may have some improvement after a detethering procedure, those presenting with curves >40 degrees or thoracic neurologic levels had no improvement in their scoliosis.