title: Tethered cord syndrome in childhood: special emphasis on the surgical technique and review of the literature with our experience.
abstract: OBJECTIVE
  Surgery is the treatment of choice for children who had tethered cord     syndrome (TCS). However, a detailed technique for the release of spinal cord is     not described yet. The aims of this study are to present our series of TCS in     children and to focus on the details of surgical technique. MATERIAL and
  
  
  METHODS
  Forty-nine children with tethered cord syndrome underwent surgical     treatment for the release of spinal cord between 2004 and 2009. The mean age was     4.6 years (2 days-13 years). Twenty (40.8%) patients were female and 29 (59.2%)     were male. Among the 49 children, 41 (83.7%) had different spinal malformations     and 8 (16.3%) had no associated lesion. Sectioning of the filum terminale,     cutting the arachnoid and fibrous bands, protection of the rootlets and     correction of the associated malformations was the standard surgical method to     release the spinal cord.
  
  
  RESULTS
  Neurological improvement was observed in 4     (8.2%) patients, while the neurological status was unchanged in the others.     Cerebrospinal fluid fistula was the main complication and was observed in 3     patients. No mortality or neurological deterioration was encountered.
  
  
  CONCLUSIONS
  Spinal cord release with appropriate technique seems to be     beneficial in maintaining neurological functioning in children with TCS.
authors.affiliation: Gulhane Military Medical Academy, Department of Neurosurgery, Ankara, Turkey.
authors.forename: Ilker
authors.initials: I
authors.lastname: Solmaz
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Izci
authors.forename: Baki
authors.initials: B
authors.lastname: Albayrak
authors.forename: Eralp
authors.initials: E
authors.lastname: Cetinalp
authors.forename: Cahit
authors.initials: C
authors.lastname: Kural
authors.forename: Goksin
authors.initials: G
authors.lastname: Sengul
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Gocmez
authors.forename: Serhat
authors.initials: S
authors.lastname: Pusat
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Tuzun
mesh_terms: D000293:Adolescent; D001099:Arachnoid / Q000002:abnormalities / Q000601:surgery; D002420:Cauda Equina / Q000002:abnormalities / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007796:Laminectomy / Q000379:methods; D008159:Lumbar Vertebrae / Q000033:anatomy & histology / Q000601:surgery; D008297:Male; D009436:Neural Tube Defects / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D013116:Spinal Cord / Q000002:abnormalities / Q000601:surgery*; D013117:Spinal Cord Compression / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome