title: Natural history of tethered cord in patients with meningomyelocele.
abstract: OBJECTIVE
  The purpose of this study was to describe the natural history of tethered cord in patients who have undergone meningomyelocele repair.
  
  
  METHODS
  We performed a retrospective review of 45 patients with a history of neonatal meningomyelocele repair who subsequently developed symptoms of tethered cord. Symptoms of tethered cord in this cohort consisted of the development of bladder spasticity or orthopedic foot deformity. None of these patients were treated with cord untethering; instead, they were treated symptomatically.
  
  
  RESULTS
  On follow-up, 40 (88.9%) of these patients subsequently required additional orthopedic or urological procedures because of further symptoms of tethered cord. The incidence of progression of tethered cord syndrome is 27.5, 40, and 60% at 1, 2, and 5 years, respectively.
  
  
  CONCLUSIONS
  Although this study does not address the question whether cord untethering will prevent further symptom development, these results do provide a strong rationale for consideration of an untethering procedure in patients with repaired meningomyelocele at the time of the onset of symptoms of tethered cord.
authors.affiliation: Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota 55905, USA. phuong.loi@mayo.edu
authors.forename: Loi K
authors.initials: LK
authors.lastname: Phuong
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Schoeberl
authors.forename: Corey
authors.initials: C
authors.lastname: Raffel
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018450:Disease Progression; D005531:Foot Deformities, Acquired / Q000209:etiology / Q000628:therapy; D006801:Humans; D007223:Infant; D008591:Meningomyelocele / Q000601:surgery*; D009436:Neural Tube Defects / Q000209:etiology* / Q000503:physiopathology; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000628:therapy