{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T20:44:31Z","timestamp":1765485871879},"reference-count":10,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2015,4]]},"abstract":"\nOBJECT<\/jats:title>\nTethered cord syndrome (TCS) is a common spinal abnormality. In this study, the authors analyzed demographics, complications, and outcomes in children and adolescents who underwent surgery for TCS.<\/jats:p><\/jats:sec>\n\nMETHODS<\/jats:title>\nUsing the national Kids' Inpatient Database (KID), the authors retrospectively identified patients with a primary diagnosis of TCS who were treated with spinal laminectomy and discharged in 2000, 2003, 2006, and 2009. Descriptive analysis was provided for patient- and hospital-level characteristics. Mortality, complications, non-routine discharges, in-hospital length of stay (LOS), and total charges were documented for the entire cohort and age-specific cohorts (0\u20135, 6\u201310, 11\u201315, and 16\u201320 years). Comparisons by complications and age groups were conducted.<\/jats:p><\/jats:sec>\n\nRESULTS<\/jats:title>\nA total of 7397 children and adolescents met the criteria in the 4 studied years. The mean age was 5.7 years; 55.3% of patients were younger than 5 years, 21.5% were 6\u201310 years, and 16.2% were 11\u201315 years. Most surgeries were performed in patients who were female (55.0%) and white (64.4%) and were performed at large (49.8%), teaching (94.2%), and urban (99.1%) children's (89.3%) hospitals. The trend showed an increase in prevalence from 2000 (19.9%) to 2009 (29.6%). Common comorbidities included anomalies in spinal curvature (16.7%), urinary or bladder dysfunction (14.3%), and spinal stenosis\/spondylosis (1.4%). Non-routine discharges (3.3%) were significantly higher with advancing age, increasing from 2.2% in those younger than 5 years to 9.0% in those older than 15 years (p < 0.0001). There was a similar increasing trend for complications (6.8% to 13.9%, respectively, p < 0.0001) and average LOS (3.5 to 5.1 days, respectively, p < 0.0001). Hospital charges increased with age from an average of $28,521 in those younger than 5 years to $36,855 in those older than 15 years (p < 0.0001).<\/jats:p><\/jats:sec>\n\nCONCLUSIONS<\/jats:title>\nThere was a steady trend of increasing operative treatment for TCS over the more recent years. The nationwide analysis was also indicative of an existing disparity, based on age, in complications, outcomes, and charges following TCS surgical correction. Older children tended to have more complications, longer LOS, more non-routine discharges, and higher hospital costs. The results are highly supportive of surgery at a younger age for this condition. Future research should investigate this correlation, especially considering the efforts to control and reduce health care costs.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.9.peds14241","type":"journal-article","created":{"date-parts":[[2015,1,5]],"date-time":"2015-01-05T16:54:28Z","timestamp":1420476868000},"page":"427-433","source":"Crossref","is-referenced-by-count":13,"title":["Disparities in clinical and economic outcomes in children and adolescents following surgery for tethered cord syndrome in the United States"],"prefix":"10.3171","volume":"15","author":[{"given":"Faris","family":"Shweikeh","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lutfi","family":"Al-Khouja","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"Nu\u00f1o","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Patrick","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles;"},{"name":"Department of Neurosurgery, University of California Davis Medical Center, Sacramento, California; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doniel","family":"Drazin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew A.","family":"Adamo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Albany Medical Center, Albany, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-peds14241","series-title":"Pediatr Neurosurg","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1159\/000345829","article-title":"Primary tethered cord syndrome\u2014clinical and urological manifestations, diagnosis and management: a prospective study","volume":"48","author":"Ailawadhi","year":"2012"},{"issue":"2","key":"b2-peds14241","series-title":"Neurosurg Focus","first-page":"E2","article-title":"Tethered cord syndrome in children: a review","volume":"23","author":"Bui","year":"2007"},{"issue":"1","key":"b3-peds14241","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E9","DOI":"10.3171\/2010.3.FOCUS1085","article-title":"Spinal cord traction, vascular compromise, hypoxia, and metabolic derangements in the pathophysiology of tethered cord syndrome","volume":"29","author":"Filippidis","year":"2010"},{"issue":"1","key":"b4-peds14241","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E1","DOI":"10.3171\/2010.3.FOCUS1079","article-title":"Tethered cord syndrome: a review of the literature from embryology to adult presentation","volume":"29","author":"Hertzler","year":"2010"},{"key":"b5-peds14241","series-title":"Childs Brain","first-page":"145","article-title":"The tethered spinal cord: its protean manifestations, diagnosis and surgical correction","volume":"2","author":"Hoffman","year":"1976"},{"key":"b6-peds14241","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"48","DOI":"10.3171\/jns.1990.73.1.0048","article-title":"Management and long-term follow-up review of children with lipomyelomeningocele, 1952\u20131987","volume":"73","author":"Kanev","year":"1990"},{"issue":"2","key":"b7-peds14241","series-title":"Neurosurg Focus","first-page":"E3","article-title":"Tethered cord syndrome: nationwide inpatient complications and outcomes","volume":"23","author":"Lad","year":"2007"},{"key":"b8-peds14241","series-title":"Neurol Res","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1179\/016164104225017974","article-title":"Tethered cord syndrome in childhood: diagnostic features and relationship to congenital anomalies","volume":"26","author":"Michelson","year":"2004"},{"key":"b9-peds14241","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/j.wneu.2011.05.017","article-title":"Outcome, reoperation, and complications in 99 consecutive children operated for tight or fatty filum","volume":"77","author":"Ostling","year":"2012"},{"issue":"2","key":"b10-peds14241","series-title":"Neurosurg Focus","first-page":"E6","article-title":"Pathophysiology of tethered cord syndrome and similar complex disorders","volume":"23","author":"Yamada","year":"2007"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/15\/4\/article-p427.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/15\/4\/article-p427.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/15\/4\/article-p427.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T20:01:58Z","timestamp":1681588918000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/15\/4\/article-p427.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,4]]},"references-count":10,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2014.9.peds14241","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,4]]}}}