Patients often think that they can be cured after surgery, but for patients with spinal cord embolism syndrome, it is not that easy. Even after surgery, many patients still have “spinal cord tethering” on their MRI films. First of all, the fundamental point is that spinal cord embolization surgery does not change the position of the spinal cord cone, which remains low after surgery and remains with the patient for life. Therefore, when we review the MRI after surgery, we can still see that the spinal cord cone is low, and the “spinal cord tethering” phenomenon still exists. However, by removing the adhesions and spinal cord traction, the spinal cord tethering is actually relieved. Secondly, there are many factors that determine what problems can be solved by surgery, such as the severity of the embolism, the cause of the disease, the timing of surgery, postoperative care and rehabilitation, and so on. Simply put, surgery may only completely cure spinal cord embolism syndrome if the symptoms are not yet significant or only mild and the function of the nerves has not yet been irreversibly damaged. Even then, a longer period of review is required to ensure that the surgery has permanently resolved the problem. However, in some children with severe spinal cord embolism syndrome, complete cure cannot be achieved despite early nerve release surgery because of the severity of the neurodevelopmental malformation. However, early and complete release can minimize the harm. For most patients who develop significant urinary, fecal, and lower extremity dysfunction, even if the surgery is successful, it is unlikely to return to full normalcy, and close observation is required throughout life to prevent kidney damage, or other dysfunctions from becoming more severe. Therefore, for most patients, treatment is effective in relieving symptoms to some extent, or delaying the onset of symptoms, but sometimes it does not completely resolve the symptoms caused by spinal embolism. This is why the postoperative MRI still shows the “presence of spinal cord tethering”.
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