Tethered cord syndrome: surgical outcome of 43 cases and review of literatures

Objective To evaluate the surgical treatment of tethered cord syndrome (TCS), a prospective analysis of 43 patients operated at Neurosurgery Department Zagazig University hospitals from May 2013 to January 2017 with 1 year follow-up had been done. Patients and methods Adult and children patients with tethered cord syndrome subjected to microscopic surgeries for release of cord and nerves tethering with exclusion of primary repair of meningiomyelocele, paraplegic patients, hydrocephalic patients, and ages below 2 years old. Magnetic resonance imaging (MRI) of the spine was done for all patients and urodynamic studies for patients more than 6 years old preoperative and postoperative after 1 year of surgery. Results Ten patients were adults > 18 years old and male to female ratio was about 2:1. All patients presented with multiple clinical manifestations which either improved or stable during follow-up after surgery. Controllable complications occurred: cerebrospinal fluid (CSF) leak in 18.6% and wound infection in 4.7%. Urodynamic studies improved in 73% of patients after surgery and children showed significant improvement in all symptoms except back pain than adult patients. Conclusion Microscopic surgery is of value for patients suffering tethered cord syndrome with low risk of complications.