Israeli hospital performs first spinal-shortening surgery for tethered cord syndrome

Avia, 23, has spent years living with tethered cord syndrome, a neurological condition in which the spinal cord is abnormally attached to surrounding tissue, causing it to be stretched and potentially leading to nerve damage and severe pain. After a childhood operation helped only partly, her symptoms worsened in recent years, including leg weakness, bladder and bowel control problems, and increasing pain.

About three weeks ago, Avia became the first patient in Israel to undergo a new spinal-shortening procedure at Ichilov Medical Center in Tel Aviv. The six-hour surgery reduced her height from 1.67 meters to 1.65 meters in order to relieve tension on the tethered spinal cord. She said she is in early recovery and is glad she chose it, adding that she had always secretly wanted to be a bit shorter.

Dr. Morsi Chachan, who heads the spine service in Ichilov’s orthopedic division, said tethered cord syndrome is rare, occurring in about one in 3,000 to 4,000 births. He said the standard surgery is to release the spinal cord, but results are often limited when the problem returns after earlier operations, which is why doctors turned to the newer shortening approach. So far, only about 200 such operations have been performed worldwide, mostly in the United States.

Avia had already undergone a release operation as a child, but later developed worsening weakness in her left leg, deformity that required orthopedic surgery, and from age seven needed self-catheterization. She later received an automatic military exemption, challenged it, and served as a military intelligence officer. In the past year and a half, her condition deteriorated further, especially during intense military service in the war period, when she also missed medical follow-ups.

The recent procedure removed most of one vertebra and the disc next to it, shortening the spine by about 2 to 2.5 centimeters, the amount doctors say is needed to meaningfully reduce tension. The team used computer simulation and CT-based navigation to lower the risk of nerve injury or paralysis. Avia was walking the day after surgery and is now in rehabilitation; doctors say her foot weakness has already improved and bladder control may take months to recover.