{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T23:17:09Z","timestamp":1776122229192,"version":"3.50.1"},"reference-count":12,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Untethering surgery for a tight filum terminale is a common treatment with considerable efficacy and safety. On the other hand, retethering has been reported to occur. One of the major mechanisms of retethering is adherence of the cut end of the sectioned filum to the midline dorsal dural surface. To prevent retethering, the authors sectioned a filum terminale at the rostral level to the dural incision to keep the distance between the cut end of the sectioned filum and the dural incision and investigated whether this procedure decreased the occurrence of retethering.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Among the patients who underwent untethering surgery for a tight filum terminale between 2012 and 2016, patients followed up more than 5 years were included in the study. Symptoms, comorbid malformations, preoperative imaging, surgical details, perioperative complications, and long-term outcomes were reviewed retrospectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Retrospective data for a total of 342 cases were included. The median age at surgery was 11 months (range 3\u2013156 months). Preoperative MRI revealed 254 patients (74.3%) had a low-set conus. There were 142 patients (41.5%) with filar lipoma and 42 patients (12.3%) with terminal cyst. Syringomyelia was found in 29 patients (8.5%). In total, 246 patients (71.9%) were symptomatic and 96 patients (28.1%) were asymptomatic. There were no perioperative complications that required surgical intervention or prolonged hospitalization. The mean postoperative follow-up was 88 months (range 60\u2013127 months). There were 4 patients (1.2%) with retethering who presented with bladder and bowel dysfunction. The mean time from initial untethering to retethering was 54 months (range 36\u201380 months). All 4 patients underwent untethering surgery, and preoperative symptoms resolved in 3 patients.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>The retethering rate after untethering surgery for a tight filum terminale in our series was lower than those in previously reported studies. Sectioning the filum terminale at the rostral level to the dural incision was considered an effective way to prevent retethering.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.3.peds22542","type":"journal-article","created":{"date-parts":[[2023,5,20]],"date-time":"2023-05-20T16:56:19Z","timestamp":1684601779000},"page":"158-162","source":"Crossref","is-referenced-by-count":1,"title":["Prevention of retethering in untethering surgery of a tight filum terminale"],"prefix":"10.3171","volume":"32","author":[{"given":"Shotaro","family":"Ogawa","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, National Center for Child Health and Development, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideki","family":"Ogiwara","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Center for Child Health and Development, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"J Neurosurg Pediatr","first-page":"42","article-title":"Retethering of transected fatty filum terminales","volume":"7","author":"Ogiwara H","year":"2011","unstructured":"Ogiwara H, Lyszczarz A, Alden TD, Bowman RM, McLone DG, Tomita T. Retethering of transected fatty filum terminales. J Neurosurg Pediatr. 2011;7(1):42\u201346.21194286"},{"issue":"6","key":"b2","series-title":"Neurosurgery","first-page":"1594","article-title":"Symptomatic retethering of the spinal cord after section of a tight filum terminale","volume":"68","author":"Yong RL","year":"2011","unstructured":"Yong RL, Habrock-Bach T, Vaughan M, Kestle JR, Steinbok P. Symptomatic retethering of the spinal cord after section of a tight filum terminale. Neurosurgery. 2011;68(6):1594\u20131602.21346653"},{"issue":"1","key":"b3","series-title":"World Neurosurg","first-page":"187","article-title":"Outcome, reoperation, and complications in 99 consecutive children operated for tight or fatty filum","volume":"77","author":"Ostling LR","year":"2012","unstructured":"Ostling LR, Bierbrauer KS, Kuntz C IV. Outcome, reoperation, and complications in 99 consecutive children operated for tight or fatty filum. World Neurosurg. 2012;77(1):187\u2013191."},{"issue":"6","key":"b4","series-title":"Pediatr Neurosurg","first-page":"335","article-title":"Retethering in children after sectioning of the filum terminale","volume":"48","author":"Vassilyadi M","year":"2012","unstructured":"Vassilyadi M, Tataryn Z, Merziotis M. Retethering in children after sectioning of the filum terminale. Pediatr Neurosurg. 2012;48(6):335\u2013341.23920323"},{"issue":"7","key":"b5","series-title":"Childs Nerv Syst","first-page":"1499","article-title":"Retethering after transection of a tight filum terminale, postoperative MRI may help to identify patients at risk","volume":"36","author":"Finger T","year":"2020","unstructured":"Finger T, Schaumann A, Grillet F, Schulz M, Thomale UW. Retethering after transection of a tight filum terminale, postoperative MRI may help to identify patients at risk. 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Neurosurgery. 1991;29(5):785\u2013788.1961415"},{"issue":"2","key":"b10","series-title":"Neurosurgery","first-page":"253","article-title":"Long-term outcome of total and near-total resection of spinal cord lipomas and radical reconstruction of the neural placode, part II: outcome analysis and preoperative profiling","volume":"66","author":"Pang D","year":"2010","unstructured":"Pang D, Zovickian J, Oviedo A. Long-term outcome of total and near-total resection of spinal cord lipomas and radical reconstruction of the neural placode, part II: outcome analysis and preoperative profiling. Neurosurgery. 2010;66(2):253\u2013273.20042988"},{"issue":"9","key":"b11","series-title":"Childs Nerv Syst","first-page":"1085","article-title":"Incidence of symptomatic retethering after surgical management of pediatric tethered cord syndrome with or without duraplasty","volume":"25","author":"Samuels R","year":"2009","unstructured":"Samuels R, McGirt MJ, Attenello FJ,  Incidence of symptomatic retethering after surgical management of pediatric tethered cord syndrome with or without duraplasty. Childs Nerv Syst. 2009;25(9):1085\u20131089."},{"issue":"1","key":"b12","series-title":"Childs Nerv Syst","first-page":"23","article-title":"Role of surgery for maintaining urological function and prevention of retethering in the treatment of lipomeningomyelocele: experience recorded in 75 lipomeningomyelocele patients","volume":"19","author":"Kang JK","year":"2003","unstructured":"Kang JK, Lee KS, Jeun SS, Lee IW, Kim MC. Role of surgery for maintaining urological function and prevention of retethering in the treatment of lipomeningomyelocele: experience recorded in 75 lipomeningomyelocele patients. Childs Nerv Syst. 2003;19(1):23\u201329.12541082"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/32\/2\/article-p158.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/32\/2\/article-p158.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/32\/2\/article-p158.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T13:02:48Z","timestamp":1733490168000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/32\/2\/article-p158.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,1]]},"references-count":12,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2023.3.peds22542","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,1]]}}}