title: Long-term outcomes of surgical treatment for tethered cord syndrome.
abstract: Surgical outcomes for tethered spinal cord syndrome (TCS) associated with low-lying conus medullaris were evaluated. We investigated the long-term results of untethering the spinal cord and dural plasty in surgical patients with a wide age range. Improvement of bladder dysfunction and suppression of leg deformity progression were noted in two pediatric patients. However, severe urinary dysfunction generally remained postoperatively. Adult patients commonly showed low back or leg pain as clinical manifestations. In seven adult patients, urinary dysfunction also improved. Neurologic findings and urinary deficits showed a favorable improvement mostly in adult TCS in comparison with natal or juvenile onset of TCS. A short duration from onset to surgery and cranial movement of the conus medullaris as assessed by postoperative magnetic resonance imaging were factors indicating a favorable prognosis.
authors.affiliation: Department of Orthopaedic and Spinal Surgery, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan. haro.orth@tmd.ac.jp
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Haro
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Komori
authors.forename: Atsushi
authors.initials: A
authors.lastname: Okawa
authors.forename: Shigenori
authors.initials: S
authors.lastname: Kawabata
authors.forename: Kenichi
authors.initials: K
authors.lastname: Shinomiya
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007866:Leg / Q000002:abnormalities / Q000294:innervation / Q000503:physiopathology; D017116:Low Back Pain / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation / Q000503:physiopathology; D009436:Neural Tube Defects / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000592:standards / Q000706:statistics & numerical data*; D011379:Prognosis; D020127:Recovery of Function / Q000502:physiology; D013116:Spinal Cord / Q000002:abnormalities / Q000503:physiopathology / Q000601:surgery*; D013117:Spinal Cord Compression / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D016135:Spinal Dysraphism / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D013995:Time; D016896:Treatment Outcome; D014555:Urination Disorders / Q000209:etiology / Q000503:physiopathology / Q000601:surgery