Guest guest Posted February 12, 2001 Report Share Posted February 12, 2001 As I said in my first post- with children you must go on symptoms because the MRI is inconclusive. Give me the name of one pediatric neurosurgeon that wil do a retether based on an MRI in a child. For children (clarifying: age birth through about 12) symptoms are the key factor in doing a second and further detether. Dr. Neil Feldstein did a Q & A for the LFSN newsletter last yr and stated this- Dr. McLone has also advised that an MRI be done to rule out further complications but that symptoms by a guidepost as to when/if surgery is required. Dr. wrote a paper in 1996 stating that any follow up MRI's after the initial detether are done if a retether is suspected- before going into surgery- to show placement of original tether and any growth or abnormality not present in previous surgeries. Dr. Oakes, when asked at the SBAA conference in 1999, said that he goes purely by the progression of symptoms in children- that there is evidence to show that a cord may physically retether without problem and he would not advise going in surgically if there was not neurological evidence to do so. For doing surgery when there is not deficit just piles up the scar tissue and leads to further complications. Yes- there are associations with other symptoms that are not caused by tethering- that is the reason that now children are usually followed through in a spina bifida or myelo clinic at a 6 month interval for a yr or so and then yearly. This keeps a check on symptoms of retethering vs symptoms of associated diagnosis. As a reference: Tethered Cord Syndrome by Shokei Yamada paraphrasing: An MRI will always seems tethered. The questions is clinical vs physical. The determining factor is new symptoms or the progression of neurological defiecits. Bonnie Borchert -- Bonnie mom to Josie 2/16/95, Marielle 4/14/97, and 1/13/00 Lipomyelomeningocele Family Support Group http://www.mindspring.com/~borchert/index.htm ****** " Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has. " - Margaret Mead Quote Link to comment Share on other sites More sharing options...
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