Effect of Tethered Cord Release on Progression of Pediatric Scoliosis: A Systematic Review

Abstract

Abstract Background Tethered cord syndrome is one of the intraspinal anomalies, caused by abnormal fixation of the spinal cord and classically result in low-lying and immobile conus medullaris. The incidence of TCS is estimated to be 0.05 to 0.25 per 1000 births. That abnormal fixation of the spinal cord may result from many causes, including intraspinal lipoma, lipomyelomeningocele, tight or thickened filum terminale, or scarring from previous myelomeningocele repair. Methodology All available studies concerning tethered cord associated with scoliosis and the progression rate of scoliosis after release of tethered cord including randomized controlled studies, cohort studies, and case series was reviewed in addition to the references of the included articles. Systematic reviews, technical notes, letters, and comments was excluded. Studies not written in English was excluded. Patients since birth up to 16 years old, patients with tethered cord associated with scoliosis. Results The current evaluation reveals that tethered cord release improve\stable the scoliosis angle by only 47% and 40% of patients required fusion despite the untethering, there are other factors affecting the progression such as riser grade and age. Conclusion Nevertheless, the lack of good quality evidence and scarcity of the literature on the topic was also propounded by this review. Prospective, randomised and multicentre RCT’s are required to establish the effect of this procedure on the progression of the deformity.