243. Retrospective Review of Tethered Cord Release Associated with Scoliosis

Authors: Nolan Rea; Mark Krieger, MD (Los Angeles, CA)

Introduction:

Pediatric scoliosis can be a potentially lifelong condition, and literature on its etiology remains inconclusive. Scoliosis is often associated with tethered spinal cord. The primary goal of this research is to examine if tethered cord release (TCR) in patients presenting with scoliosis decreases rate of the progression of scoliosis.

Methods:

An IRB-approved, 10-year retrospective study was undertaken at a single institution. Between 2007-2017, 34 patients who presented with scoliosis received TCR. Cobb angles at presentation of tethered cord, after TCR, and at last follow-up after TCR were documented. Additional variables studied included orthopedic interventions, presence of Chiari I malformation or syringomyelia, conus level, and complexity of NTD. Chi-square analysis was utilized to test for significance between TCR and Cobb angle changes. Additional variables were also tested against Cobb angle changes using chi-square analysis.

Results:

Thirty-four patients had complete data sets. Of these, 20 (59%) patients had increased spinal curvature following TCR. Sixteen (47%) patients received orthopedic surgical intervention for their scoliosis. Two patients presented with Chiari I malformations, and 11 presented with syringomyelia. The majority of closed NTDs presented with fatty filum terminale (56%). Conus levels ranged from L1 to S1, with a predominance at L3 (38%). No significance was found between TCR and scoliosis curvature.

Conclusion:

This study describes the natural history of scoliosis progression after tethered cord. Although this series was limited by single site data and small sample size, tethered spinal cord and scoliosis appear to be independent of one another. A controlled study of patients with scoliosis either receiving TCR or not may provide more insight as to the association of TCR with scoliosis.