Spinal Cord Detethering Cost in Israel

Spinal cord detethering is a surgical procedure to release a spinal cord that is abnormally attached to surrounding tissues, preventing normal movement and causing progressive nerve damage. It treats both congenital (e.g., spina bifida) and acquired (e.g., scarring from surgery or trauma) causes. The goal is to relieve tension on the spinal cord, reduce symptoms like pain, weakness, or bladder issues, and prevent further neurological decline.

Consult a neurosurgeon or spine specialist if you or your child experiences:

• Back or leg pain
• Numbness, tingling, or weakness in the legs
• Gait abnormalities
• Loss of bladder or bowel control
• Progressive scoliosis or foot deformities
• Worsening symptoms after previous spinal surgery

Early intervention is crucial for preventing irreversible nerve damage, especially in children or when symptoms are worsening.

Preparation includes:

• Neurological examination
• MRI or CT scan of the spine to assess the tethering and related anomalies
• Urodynamic testing (if bladder symptoms are present)
• Review of medications, especially blood thinners
• Fasting for 6\\u20138 hours before surgery
• Detailed discussion of surgical risks, recovery expectations, and long-term monitoring needs

In pediatric cases, consultation with a pediatric neurosurgeon and an anesthesiologist may also be required.

Spinal cord detethering is performed under general anaesthesia. The steps include:

• A small incision is made over the lower back (usually at the lumbar or sacral level)
• The surgeon opens the spinal canal to expose the tethered cord
• The abnormal attachments (scar tissue, fatty filum, or other adhesions) are carefully released to free the spinal cord
• If necessary, microsurgical techniques and intraoperative monitoring are used to protect nerve function
• The dura (spinal covering) is closed tightly to prevent cerebrospinal fluid leakage

The goal is to relieve tension, restore mobility of the cord, and preserve neurological function.

The surgery typically takes 2 to 4 hours, depending on the complexity and presence of associated abnormalities. Hospital stays usually range from 2 to 5 days for monitoring and early recovery.

Potential risks include:

• Infection
• Bleeding
• Cerebrospinal fluid leak
• Nerve injury
• Paralysis or sensory changes (rare)
• Re-tethering over time, which may require repeat surgery
• Bladder or bowel function changes

Utilising experienced neurosurgical care and monitoring significantly reduces complication risks.

• Relief from neurological symptoms such as pain, weakness, and sensory issues
• Improved or stabilised bladder and bowel function
• Prevention of further spinal cord damage
• Improved mobility and posture, especially in children
• May slow or stop scoliosis progression

Early surgical treatment often results in better long-term outcomes, particularly in younger patients.

Patients are typically monitored for a few days post-surgery. Pain and stiffness at the incision site are common. Limited activity is advised for several weeks to allow healing. Physical therapy may be recommended to regain strength and mobility. Full recovery generally takes 4\\u20138 weeks, but some neurological symptoms may take longer to improve. Follow-up imaging and regular neurological exams are important to monitor for potential re-tethering.

Spinal cord detethering has a high success rate for symptom stabilisation and improvement, primarily when performed early. Around 70\\u201390% of patients experience relief from symptoms, although re-tethering can occur in up to 30% of cases, often requiring further monitoring or intervention.