TACTICAL FEATURES OF SURGICAL TREATMENT OF COMBINED TETRING SYNDROME IN SPINAL CORD ANOMALIES

Аннотация

The results of surgical treatment of children who underwent surgery for fixed spinal cord syndrome were analyzed. The features of the surgical technique for eliminating fixation of the spinal cord in closed dysraphism were determined, which made it possible to improve the results of treatment. In total, from 2019 to 2022, 61 children were operated on for a fixed spinal cord. Of these, in 52 (85.2%) patients, fixation of the terminal filament was combined with lipomeningocele, diastematomyelia, or myelomeningocele. All patients underwent a detailed study with magnetic resonance imaging (MRI) and computed tomography MSCT, performed electroneuromyography (ENMG), as well as tractography. In all these patients, the release of the stretched spinal cord and roots and the dissection of the arachnoid and fibrous cords were performed surgically using intraoperative monitoring and microscopic techniques. The results of the study were compared with a retrospective control group of patients, consisting of 55 patients. At the same time, it was found that the approach used by us significantly improved the condition in the long-term period according to electroneuromyography and neurological deficit in 29.5% of patients with pelvic disorders and 19.6% of patients with motor disorders in the main group.