Surgical Management of Tethered Spinal Cord Syndrome in Adults - Our Experience

Dr. B. B. Joginath, Dr. K. Jagadeeswar Reddy, Dr. R. Deepthi

Abstract: Background: Tethered spinal cord syndrome is a rare entity that usually presents with multiple neurological symptoms including lower extremity pain, backache, lower extremity muscle weakness and bowel bladder disturbance, but unlike children pain is a predominant clinical symptom. Materials and Methods: Case records of 10 patients aged ?18 years who had undergone surgery with a diagnosis of TCS between 2013 and 2018 were reviewed. Patients who have underwent surgery earlier for tethered cord or for diastematomyelia/spinal dysraphism were excluded from the study. Results: Low backache was the most common presenting symptom. At the time of final follow - up, 7 (77.7%) patients had shown improvement in backache. Weakness improved by at least one grade in five (71.42%) patients. Bladder symptoms improved in two (40%) patients. Conclusion: In case of symptomatic patient with low - lying cord, surgical management with detethering of the spinal cord is an advisable option for better prognosis.

Keywords: Adult tethered cord syndrome, Tethered cord, Detethering, Occult spinal dysraphism, Pain, Weakness, Bowel and bladder involvement