Clinical Study On The Treatment For Relaxation Of Tethered Cord Syndrome Combined Epidrual And Intradural

Objective Through the relaxation of nerve root and excision of the filum terminale combine epidrual and intradural to study the treatment in children with tethered cord syndrome.Method Eighty-two patients who were identified as tethered cord syndrome were divided into two groups.The routine group consisted 22 patients who underwent routine procedure including release of the tethered spinal cord and transection of filum terminale.The modified group was composed of 60 patients who underwent modified procedure.In that technique, the microsurgical technique was used to release the tethered spinal cord and nerve root and transection of filum terminale from epidrual and intradural. And clinical outcomes were evaluated in all patients based on Hoffman’s functional grading criteria and excellent,effective, ineffective and aggravation.Clinical data was analyzed by SPSS16.0 statistics software and the two groups of patients postoperative neurological function was contrasted with Chi-square test,matched t test and Rank sum test.Results All patients were followed-up for six months.In the routine group,2 patients had temporary cerebrospinal fluid(CSF) leakage,1 children had wound infection and 1 scalp hydrops was identified. The routine group patients postoperative neurological function was recorded,among them 22.7% excellent,27.3% effective,36.4% not changed and 13.4% aggravated.There is no statistical difference of Hoffman’s functional grading criteria between preoperative and postoperative in routine group(p>0.05).In the modified group,there is no CSF leakage occur,1 children had scalp hydrops.The modified group patients postoperative neurological function was recorded, among them 31.7% excellent,60% effective, 8.3% not changed and 0% aggravated.The Hoffman’s functional grading criteria between preoperative and postoperative in modified group had statistic significance(p<0.05).There is no statistical difference between preoperative and postoperative in routine group of 11 asymptomatic patients (p>0.05).In the modified group,71 symptomatic patients between preoperative and postoperative in modified group had statistic significance(p<0.05).Conclusions The application of releasing the tethered spinal cord and nerve root and transection of the filum terminale from epidrual and intradural to treat TCS have more efficiently than routine procedure and greater improve neurological function.