Management of adult tethered cord syndrome: our experience and review of literature.
BACKGROUND
Tethered cord syndrome (TCS) is a complex clinicopathologic entity, mostly described in children with limited number of studies describing in adults. This unique and rare subgroup of patients presents with characteristic features of TCS, but unlike children, pain is a predominant clinical symptom.


METHODS
Case records of 24 patients aged ≥16 years who had undergone surgery with a diagnosis of TCS between 2001 and 2011 were reviewed. Patients who have underwent surgery earlier for tethered cord or for diastematomyelia/spinal dysraphism and patients who had radiological evidence of tethering elements like lipoma of the cord on magnetic resonance imaging (MRI) were excluded from the study.


RESULTS
Low backache was the most common presenting symptom. At the time of final follow-up, 15 (83.3%) patients had shown improvement in backache. Weakness improved by at least one grade in seven (77.8%) patients. Bladder symptoms improved in six (50%) patients.


CONCLUSIONS
In case of symptomatic patient with low-lying cord, detethering is an advisable option.
Kanwaljeet
K
Garg
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Vivek
V
Tandon
Rajinder
R
Kumar
Bhawani Shankar
BS
Sharma
Ashok Kumar
AK
Mahapatra
D000293:Adolescent; D000328:Adult; D001416:Back Pain / Q000150:complications / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009436:Neural Tube Defects / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods; D012196:Review Literature as Topic; D016896:Treatment Outcome; D055815:Young Adult