Tethered Cord

Zusammenfassung

Das tethered cord (TC), welches im Rahmen von angeborenen Fehlbildungen entsteht, ist ein heterogenes Krankheitsbild. Offene Neuralrohrdefekte bedürfen einer unmittelbaren Versorgung nach Geburt. Bei geschlossenen Fehlbildungen ist eine operative Behandlungsindikation in Abhängigkeit von folgenden Faktoren zu stellen: Komplexität der Fehlbildung, Erfahrung des Operateurs mit spinalen Dysraphien und Progression von assoziierten neurologischen Symptomen. Das intraoperative Neuromonitoring und die Mikrochirurgie sind unabdingbare Vorrausetzungen für die Operation. Ein interdisziplinäres Team, bevorzugt in einem spezialisierten Zentrum, ist Voraussetzung für die langfristige Versorgung der durchaus komplexen Begleiterscheinungen eines TCs. Der Funktionserhalt und ggf. auch die Funktionsverbesserung mit Erhalt der Lebensqualität muss das primäre Ziel der Behandlung darstellen.

Abstract

The tethered cord (TC), which develops in the context of congenital malformations, generally represents heterogeneous entities. Open neural tube defects need surgical treatment within the first days after birth. In occult neural tube defects, surgical indication is more difficult and depends on following factors: complexity of the malformation, experience of the surgical team with spinal dysraphism and progression of related neurological dysfunction. Intraoperative Neuromonitoring and microsurgical technique are essential for its surgical treatment. An interdisciplinary team preferentially in a specialized center is an important precondition to provide long-term care and follow up of these complex clinical conditions. The preservation of function and possible improvement of neurodevelopment by keeping a decent quality of life should be the primary goal of treatment strategies.

Schlüsselwörter

Myelomeningozele - spinales Lipom - Diastematomyelie - Split Cord Malformation - Filum Terminale - Dermalsinus

Publication History

Article published online:
29 April 2021

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