Issue release date: 12.11.2024
2Ankara Numune Education and Training Hospital, Department of Neurosurgery, Ankara, Turkey
3Kanuni Sultan Suleyman Education and Research Hospital, Department of Neurosurgery, Istanbul, Turkey
4Ondokuz Mayıs University, School of Medicine, Department of Neurosurgery, Samsun, Turkey
5Yeditepe University, School of Medicine, Department of Neurosurgery, Istanbul, Turkey and University of Health Sciences Umraniye Training and Research Hospital, Department of Neurosurgery, Istanbul, Turkey DOI : 10.5137/1019-5149.JTN.29771-20.2 AIM: To demonstrate the various technical advantages of minimally invasive endoscopic untethering of tight filum terminale for the treatment of tethered cord syndrome (TCS).
MATERIAL and METHODS: In five pediatric cases of TCS, we performed untethering by using the endoscopic technique. The age of the patients were 6, 7, 8, 9, and 12 years old. We used a nasal speculum of the transsphenoidal approach during the endoscopic surgical procedure.
RESULTS: All the procedures were performed uneventfully, except for one case with a split cord malformation that showed neurologic deterioration caused by excision of the diastematomyelic fibrous septum at the thoracic level (unrelated to the endoscopic procedure at the L5-S1 level). This patient was referred to a rehabilitation clinic 5 days after surgery and showed significant improvement by the third postoperative month. The other four patients were discharged 1 day after the operation.
CONCLUSION: Endoscopic release of filum terminale is a safe technique especially if it is performed with neuromonitoring. This technique may shorten the length of hospital stay and reduce perioperative blood loss. However, futher studies with a larger number of patients and long-term follow-up are needed.
Keywords : Minimally invasive, Endoscopy, Tethered cord, Filum terminale