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Introduction of a urodynamic score to detect pre- and postoperative neurological deficits in children with a primary tethered cord

Meyrat, Blaise ; Tercier, Stéphan ; Lutz, Nicolas ; Rilliet, Bénédict ; Forcada-Guex, Margarita ; Vernet, Olivier

In: Child's Nervous System, 2003, vol. 19, no. 10-11, p. 716-721

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    Titel
    • Introduction of a urodynamic score to detect pre- and postoperative neurological deficits in children with a primary tethered cord
    Autor
    • Meyrat, Blaise. Department of Pediatric Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), 1011, Lausanne, Switzerland
    • Tercier, Stéphan. Department of Pediatric Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), 1011, Lausanne, Switzerland
    • Lutz, Nicolas. Department of Pediatric Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), 1011, Lausanne, Switzerland
    • Rilliet, Bénédict. Department of Neurosurgery, Centre Hospitalier Universitaire Vaudois (CHUV), 1011, Lausanne, Switzerland
    • Forcada-Guex, Margarita. Division of Neonatology, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois (CHUV), 1011, Lausanne, Switzerland
    • Vernet, Olivier. Department of Neurosurgery, Centre Hospitalier Universitaire Vaudois (CHUV), 1011, Lausanne, Switzerland
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • Child's Nervous System, 2003, vol. 19, no. 10-11, p. 716-721. Springer-Verlag
    Andere elektronische Ausgabe
    OAI-PMH-ID
    • oai:doc.rero.ch:313313
    Summary
    Object: An increasing number of asymptomatic children are diagnosed with occult spinal dysraphism, raising the question of their optimal management. Urodynamic study (UDS) is the most reliable method of detecting neuro-urological abnormalities in these children. The rate of postoperative retethering ranges from 10 to 20% and is not always immediately clinically significant. The aim of this prospective study was to develop a reliable method that could be used in the preoperative assessment and postoperative follow-up of children with a tethered cord syndrome (TCS). Methods: From 1989 to 1997, 15 children underwent spinal cord untethering for TCS. Preoperatively, patients were assessed with MRI and UDS. Postoperative UDS were repeated at 6- to 12-month intervals. Four UDS parameters were identified, graded, and added to obtain a UDS score. A group of 38 children without dysraphic condition was used as control and allowed the calculation of a normal score. Conclusions: There was a statistically significant difference in the preoperative UDS scores between the control group and the study group (p<0.001). Postoperatively, there was a statistically significant improvement (p<0.001) in UDS scores. UDS score is a reliable tool for identifying and quantifying neuro-urological disorders in patients with TCS. Postoperatively, this score was useful in the early diagnosis of spinal cord retethering