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expected.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"One operation; further surgery only for retethering or complications."},"stages":[{"code":"cord_untethering","label":"Microsurgical release of the tethered spinal cord","after":{"min":0,"max":0,"unit":"days","qualifier":"Single operation; no preceding stage required."}}],"qualifier":"Single-stage procedure."},"success":{"metric":"Symptom stabilization or improvement","value":70,"unit":"percent of patients","horizon":"2 years after surgery","population":"Adults with symptomatic tethered cord undergoing untethering","evidence_status":"limited"},"techniques":[{"name":"Microsurgical cord untethering with filum sectioning","suits_whom":"Adults with tight filum terminale and tethered cord symptoms","recovery":"Hospital stay about 2–4 days; walking usually started early."},{"name":"Lipoma-associated untethering with partial fat debulking","suits_whom":"Adults with lipomyelomeningocele and tethered cord","recovery":"Similar hospital stay; longer recovery after extensive fat dissection."}],"treatment_conditions":["inpatient"],"treatment_duration_hours":{"min":2,"max":4,"unit":"hours","qualifier":"Typical microsurgical untethering; longer with lipoma resection or extensive dissection."},"initial_assessment_documents":["Spine MRI report and images","Urodynamic study report, if performed","Neurological examination and bladder function notes","Prior spine surgery records, if any","Photos of lower back skin marks, if present"],"travel_trips":{"min":1,"max":2,"one_trip_possible":true,"qualifier":"Single operation; second trip only for complications or review."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check the surgeon’s training and qualifications","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/cosmetic-surgery-abroad/","host":"nhs.uk","quote":"what training and qualifications they have","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C2","text":"Check how many similar procedures the surgeon has performed","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/cosmetic-surgery-abroad/","host":"nhs.uk","quote":"... how many procedures like the one you're having they have done","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C3","text":"Check that the surgeon provides consultations before surgery","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/cosmetic-surgery-abroad/","host":"nhs.uk","quote":"You should have 2 consultations with the surgeon treating you before any surgery.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C4","text":"Check how aftercare will be provided after returning home","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/going-abroad-for-medical-treatment/","host":"nhs.uk","quote":"... communication between medical staff abroad and in the UK, such as exchanging medical records and arranging aftercare back home","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C5","text":"Check that you are satisfied with the clinic or hospital facilities and standards","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Are you satisfied with the facilities and standards at the clinic or hospital where you'll be treated?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"An offer does not identify the surgeon’s training or qualifications","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/cosmetic-surgery-abroad/","host":"nhs.uk","quote":"what training and qualifications they have","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F2","text":"The offer does not explain what happens if complications occur","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/cosmetic-surgery-abroad/","host":"nhs.uk","quote":"- what happens if there are complications","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F3","text":"The clinic cannot explain where follow-up appointments will occur","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/cosmetic-surgery-abroad/","host":"nhs.uk","quote":"- where follow-up appointments will be","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"warning_signs":{"status":"missing","reason":"no_official_source","checked_at":"2026-11-12","next_check_at":"2027-02-10"},"take_home":{"status":"ok","items":[{"id":"T1","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure details","source":{"url":"https://rcseng.ac.uk/patient-care/cosmetic-surgery/after-surgery/","host":"rcseng.ac.uk","quote":"After your surgery, before you leave the hospital, ask for written information about the procedure you've had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T2","text":"Home doctor needs the clinic's follow-up recommendations in a written discharge summary","document":"discharge summary","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"When you have treatment abroad, you must ask the treatment provider for their follow-up recommendations documented within a written discharge summary in English.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T3","text":"Ask for copies of all prescriptions before you leave","document":"prescription copies","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"alternatives":{"status":"ok","items":[{"id":"A1","text":"Your spina bifida is the closed form, which may not need surgery","name":"Watchful waiting","source":{"url":"https://www.nhs.uk/conditions/spina-bifida/treatment","host":"nhs.uk","quote":"Closed spina bifida does not usually need treatment, although sometimes surgery is needed.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200},"operation_id":null}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"technique_details":{"status":"ok","items":[{"id":"microsurgical-cord-untethering","name":"Microsurgical cord untethering with filum sectioning","how_it_works":{"text":"Surgery frees the spinal cord from surrounding tissue","source":{"url":"https://health.nih.gov/health-topics-a-z/spina-bifida","host":"health.nih.gov","quote":"Surgery to free the spinal cord from surrounding tissue can help prevent further nerve damage from getting worse and is often successful.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"}},{"id":"lipoma-associated-untethering","name":"Lipoma-associated untethering with partial fat debulking","how_it_works":{"status":"missing","reason":"no_official_source"},"recovery_daily":{"status":"missing","reason":"no_official_source"}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1}}},"hrefLanguages":[{"rel":"alternate","hreflang":"ru","language":"ru","href":"https://ru.bookimed.com/clinics/country=italiya/city=milan/procedure=operacia-pri-spina-bifida/"}],"offerFilters":{"offer_count":0,"price_filter":{"from":0,"to":0,"avg":0}},"rendersOffersList":false,"fewClinics":true,"topCountriesCount":0}