Abstract:

Objective

To evaluate the effects of contact lasers in the lipomyoma type of tethered cord syndrome （TCS）.

Methods

A retrospective analysis was conducted on the clinical data of 28 patients with lipomyoma type of TCS who were operated solely by one surgeon from April 2021 to June 2023. All patients received contact lasers assisted by electrophysiological monitoring， microscope and three-dimensional external view mirror. Kirollos and Van Hille grading were used to evaluate the degree of loosening of the thrombus during surgery； JOA score was used to assess the neurological function of patients before and after surgery.

Results

During the use of the contact laser，the amount of bleeding in the surgical field was minimal， with an average of 65 mL. There were no cases of infection or death after surgery， and there were no irreversible electrophysiological monitoring alarms at the end of the operation.Among 28 patients， 25 （89.29%） had complete release of the spinal cord， 2 （7.14%） had partial release，and 1 （3.57%） had no release. Twenty - eight patients showed varying degrees of improvement in postoperative JOA scores compared to preoperative levels， with particularly significant changes observed in the number of patients scoring 10-15 and 16-24. Follow up for 3-24 months showed no new cases of severe neurological dysfunction.

Conclusion

Contact lasers could accurately remove lipomatoid tissue especially mixed tough fibre for the lipomyoma type of TCS， little bleeding and low thermal damage， in favour of increasing the proportion of releasing degree， increasing the curative effect for the lipomyoma type of TCS.

Key words: Tethered cord syndrome, Lipomyoma, Contact laser, Electrophysiological monitoring