Operation Treatment And Analysis Of Curative Effect Evaluation In Children With Tethered Cord Syndrome

Objective:All the tethered cord syndrome (TCS) patients were carried by microscopic neurosurgical treatment to release the tethered spinal cord, and we use preoperative and postoperative urine flow dynamics (UDS) monitoring together with somatosensory evoked potential (SEP) examination to evaluate the treatment effectiveness. Our study is aim to provide effective treatment for TCS.Methods:Fifty children with TCS were collected by pediatric neurosurgery department of Xiang Ya hospital affiliate to Central South university from March2,2007to April23,2012. All of them underwent microneurosurgical treatment for the release of spinal cord after general anaesthesia, during the operation, Kirollos’release scale was adapt to evaluate the effectiveness of this treatment. MRI was performed in all patients after surgery to assess the level of the conus medullaris, all patients with neurological deficits received physical therapy. Twenty one patients undertook UDS monitoring, and24patients underwent SEP examination. To evaluate the effectiveness of surgical treatment, we took the method of paired t test during the data analysis of examination from preoperative and postoperative, and we did regular follow-up of this patients to comprehensively evaluate the treatment. Results:Among the50TCS patients,34(68%) patients complained lumbosacral skin tumor, and7(14%) of them combine with skin ulceration;4patients suffered from defecation dysfunction;5(10%) patients complained extremity dysfunction;48patients received absolutely released spinal cord;2patients obtained partial slacken. After the operation, all the43patients’subcutaneous lipoma were completely resected;27patients’spina bifida were cured,16patients’skin ulceration healed. Among the16patients who presented abnormal in UDS moniting,12children’s UDS data were significantly improved;19patients with abnormal SEP results before operation,16of them showed significantly shortness of lower limbs potation in postoperative SEP examination. Forty four patients undertook follow-up (for an average of22.5months), and31cases were markedly effective,10cases were effective and3cases were invalid.Conclusion:1、The detailed history, careful physical examination, and related auxiliary examination such as:X-ray, CT, MRI, can be clearly children with tethered cord syndrome diagnosis.2、In preparation for the sufficient conditions, using the microscopic operation solution separation TCS is the only effective method at present.3、Children with TCS before surgery, UDS, SEP examination results, can accurately assess the operation effect.