{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T13:35:33Z","timestamp":1783776933450,"version":"3.55.0"},"reference-count":32,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2009,4]]},"abstract":"<jats:p>Recurrent tethered cord syndrome (TCS) has been reported to develop in 5\u201350% of patients following initial spinal cord detethering operations. Surgery for multiple recurrences of TCS can be difficult and is associated with significant complications. Using a cadaveric tethered spinal cord model, Grande and colleagues demonstrated that shortening of the vertebral column by performing a 15\u201325-mm thoracolumbar osteotomy significantly reduced spinal cord, lumbosacral nerve root, and terminal filum tension. Based on this cadaveric study, spinal column shortening by a thoracolumbar subtraction osteotomy may be a viable alternative treatment to traditional surgical detethering for multiple recurrences of TCS.<\/jats:p>\n<jats:p>In this article, the authors describe the use of posterior vertebral column subtraction osteotomy (PVCSO) for the treatment of 2 patients with multiple recurrences of TCS. Vertebral column resection osteotomy has been widely used in the surgical correction of fixed spinal deformity. The PVCSO is a novel surgical treatment for multiple recurrences of TCS. In such cases, PVCSO may allow surgeons to avoid neural injury by obviating the need for dissection through previously operated sites and may reduce complications related to CSF leakage. The novel use of PVCSO for recurrent TCS is discussed in this report, including surgical considerations and techniques in performing PVCSO.<\/jats:p>","DOI":"10.3171\/2008.10.spine08123","type":"journal-article","created":{"date-parts":[[2009,5,15]],"date-time":"2009-05-15T00:22:15Z","timestamp":1242346935000},"page":"278-286","source":"Crossref","is-referenced-by-count":32,"title":["Posterior vertebral column subtraction osteotomy: a novel surgical approach for the treatment of multiple recurrences of tethered cord syndrome"],"prefix":"10.3171","volume":"10","author":[{"given":"Patrick C.","family":"Hsieh","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois;"},{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen L.","family":"Ondra","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew W.","family":"Grande","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayfield Clinic and Spine Institute, University of Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian A.","family":"O'Shaughnessy","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Bierbrauer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayfield Clinic and Spine Institute, University of Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerry R.","family":"Crone","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayfield Clinic and Spine Institute, University of Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan J.","family":"Halpin","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Suk","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler R.","family":"Koski","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziya L.","family":"Gokaslan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Kuntz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayfield Clinic and Spine Institute, University of Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0100278","series-title":"Neurosurg Clin N Am","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1016\/j.nec.2007.04.001","article-title":"Tethered cord syndrome","volume":"18","author":"Agarwalla","year":"2007"},{"key":"b2-0100278","series-title":"J Pediatr Orthop","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1097\/01241398-199711000-00014","article-title":"Surgical release of tethered spinal cord: survivorship analysis and orthopedic outcome","volume":"17","author":"Archibeck","year":"1997"},{"key":"b3-0100278","series-title":"J Spinal Disord","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1097\/00002517-199106000-00010","article-title":"Vertebral column resection and arthrodesis for complex spinal deformities","volume":"4","author":"Boachie-Adjei","year":"1991"},{"key":"b4-0100278","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1590","DOI":"10.1097\/00007632-199707150-00013","article-title":"Vertebral column resection for the treatment of rigid coronal decompensation","volume":"22","author":"Bradford","year":"1997"},{"key":"b5-0100278","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"254","DOI":"10.3171\/spi.2004.1.3.0254","article-title":"Bone morphogenetic proteins in anterior lumbar interbody fusion: old techniques and new technologies. 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