For patients with spina bifida who have tethered cord syndrome, vertebral body shortening is an option that avoids the complication risk associated with revision detethering.
Neurosurgeon Deb Bhowmick, MD, who specializes in the technique, explains that surgery to release a tethered cord is effective, but the cord can retether, and the surgery can be performed a very limited number of times due to the high risk of injury. “So the patient is left with only pain relief, as they slowly lose the ability to walk,” he said. A solution is shortening the vertebral column by removing a third to half of a vertebra and compressing the spine.
“Unlike detethering, spinal shortening is one and done,” said Bhowmick. The procedure is not new, but the tools and technology have advanced greatly in recent years.
Bhowmick estimates he is one of about a half-dozen surgeons who offer this technique. Therefore, patients will travel many miles for access. He and other surgeons offering the procedure have recently formed a consortium to discuss standards and risk reduction.