Roger Dmochowski led the peer-review process as the Associate Editor responsible for the paper.
Spinal cord transection before scoliosis correction in myelomeningocele may improve bladder function
Article first published online: 19 FEB 2013
© 2013 Wiley Periodicals, Inc.
Neurourology and Urodynamics
Volume 33, Issue 1, pages 121–128, January 2014
How to Cite
Linthorst, J. I., Veenboer, P. W., Dik, P., Pruijs, H. E.H., Han, S. K.S., de Kort, L. M.O. and de Jong, T. P.V.M. (2014), Spinal cord transection before scoliosis correction in myelomeningocele may improve bladder function. Neurourol. Urodyn., 33: 121–128. doi: 10.1002/nau.22385
Conflict of interest: none.
- Issue published online: 11 DEC 2013
- Article first published online: 19 FEB 2013
- Manuscript Accepted: 21 JAN 2013
- Manuscript Received: 19 NOV 2012
- spina bifida;
- spinal cord transection
In patients with myelomeningocele (MMC) and coexistent scoliosis, a spinal cord transection (SC-transection) is sometimes performed before scoliosis correction to prevent traction on the myelum after stretching the spinal column. Performing a SC-transection may have positive effects on bladder function, especially in case of refractory detrusor-sphincter dyssynergia. This study investigates the effects of SC-transection on lower and upper urinary tract outcomes.
All children with MMC who underwent scoliosis correction (1989–2009) were retrospectively reviewed. Cases were defined as those who underwent a SC-transection before scoliosis correction, whereas the control group comprised children who had a scoliosis correction alone. Urodynamic and clinical outcomes were examined.
A total of 7 cases and 13 controls were identified. Postoperatively, compared to the control group, cases had relatively more often improvement of compliance (improvement in 6/7 vs. 9/13) and bladder capacity (improvement in 6/7 vs. 8/13). No effect of SC-transection was found on incontinence severity, clean intermittent catheterization frequency, use of antimuscarinic drugs, or signs of renal damage on ultrasound.
SC-transection before scoliosis correction in children with MMC without lower extremity function, may improve bladder function with respect to bladder compliance and bladder capacity. Changes in symptoms or renal ultrasound were not found. No harmful effects of SC-transection were found, indicating that this procedure can be performed safely with respect to bladder function in these patients. Whether or not SC-transection should be recommended during scoliosis correction in patients with MMC to improve bladder function requires further study. Neurourol. Urodynam. 33:121–128, 2014. © 2013 Wiley Periodicals, Inc.