Background:
Early recognition of tethered cord syndrome (TCS) with accessible diagnostic methods can effectively reduce the incidence of complications. There is also a substantial need for new techniques that can quantify the postoperative changes in TCS patients. In this study, we examined the findings of spinal cord ultrasonography in patients with TCS in comparison with normal children. We also examined these ultrasound findings in a number of patients after corrective surgery.
Methods:
In this prospective cross-sectional study, 30 patients with TCS and 34 normal children of the same age were assessed. In all participants, the maximum distance of the spinal cord from the posterior canal wall was measured using ultrasonography. The location of conus medullaris was also recorded. Thirteen patients with TCS were accessible for post-operative evaluation and the effects of corrective surgery was also assessed on the studied variables in these patients.
Results:
In normal children, conus medullaris was located from L1 to L2 vertebrae, with L1 level and L1-L2 interspace being the most common (each 41.2%). In TCS patients, the most common location for conus medullaris was at L4 level (53.3%). The maximum distance of the spinal cord from the posterior wall of the spinal canal was significantly lower in TCS patients compared with normal children (2.79±0.76 vs. 1.75±0.62 mm, P<0.001). We obtained significant improvement in maximum distance of the spinal cord from the posterior wall of the canal in patients who underwent ultrasonography after the corrective surgery (1.57±0.54 mm to 2.95±0.49 mm, respectively, P=0.001).
Conclusion:
According to the results, it can be stated that the spinal cord is much closer to the posterior canal wall in TCS patients compared with normal children. However, these outcomes were improved in patients after corrective surgery.