The Clinical Study Of The Treatment Of Adult Tethered Cord Syndrome

BackgroundTethered cord syndrome (TCS) is a group of syndrome, which due to the ascent of the spinal cord limited and disproportionate to the growth of the spinal column. Surgery is still the first choice to treat the TCS. Surgery lysis by microsurgery may help decompress and spare functional neural tissue and prevent retethering of the spinal cord.ObjectiveWe use the preoperative and postoperative clinical symptoms,residual urine(RU)and complications to evaluate the effectiveness of the surgical lysis by microsurgery. Analyze the results is to provide a reliable basis for surgical treatment of TCS.MethodsThe clinical data of 31 cases with tethered cord syndrome (TCS) who underwent surgical lysis were collected by neurosurgery department of Shandong Provincial Hospital from March 31,2008 to March 4,2014. The patients were followed up for 24-60 months to observe their symptom alleviates? the preoperative and postoperative clinical symptoms and complications.We used statistical methods to analyze and evaluate the symptom alleviates, complications and prognosis.ResultsAccording to the grading system for cord untethering by Kirollos:21 of 31 patients had Grade I untethering; 9 patients had Grade Ⅱ untethering; No patients had Grade Ⅲ untethering.45.0% of patients got significant improvement; 55.0% of patients had moderate improvement and no patients had no improvement. There was no serious complication during the follow-up period of 24-60 months.ConelusionSurgery is still the only effective method for tethered cord syndrome. Early sur-gery can get the better effects, and lead to a better quality of life. Urination and defecation function disturbance, pain, motorial and sensory disturbance are the main symptoms of adult patients in clinic, which is defferent from the Children. There were fewer symptoms of the lump in adult and more symptoms by a lon-g time after the surgery once. The surgery is to reach the aim of decompress and spare functional neural tissue and prevent retethering of the spinal cord. Intrao-perative EPG monitoring of microsurgery can effectively distinguish normal ne-ural tissue and the tethering factors, then nerve injuries could be reduced or avoi-ded. The reconstruction of normal human physiological anatomy of the spinal cord can improve the functional rehabilitation of injured nerve.,and reduce the relapse of the tethered cord.