Factors Of Influence In Postoperative Results Of Adult Tethered Cord Syndrome: A Multivariate Study

ObjectiveThe purpose of this study is to screen statistically significant factors in a variety of possible factors which may affect postoperative results of adult tethered cord syndrome,and establish a model to predict the effect of sugery.MethodsA retrospective chart review was performed on patients treated for adult tethered cord syndrome at the Neurosurgical Department of the Renji Hospital between January 2008 to June2015,including 103 patients,74cases were male and 29 females.The average age at diagnosis was 29.6years old?range 18–45?.The average span from the onset to hospital surgery was 2.8 years?range from one month to 11.5 years?.Gender,age,duration of smoking,alcohol consumption,as well as preoperative imaging findings?within the spinal canal,spina bifida,scoliosis,etc.?was collected.And Hoffman neurological grade preoperative or postoperative was assessed to evaluate the surgical effects.The data was analysised with univariate chi-square test and multivariate logistic regression analysis.Results1.66 of the 103 cases enjioyed neurological function improvement after the hospitalized operation.The improvement rate of our study is64.1%.2.The univariate analysis2.1 The improvement rate of male and female patients were compared by the fourfold table Chi-square test,the result showed that the difference has no statistically significance?X²=0.0708,P=0.7902?.2.2 The improvement rate of the three age-groups were compared by the Chi-square test,the result showed that the difference has statistically significance?X²=18.8877,P<0.0001?.2.3 The improvement rate of smokers and non-smokers were compared by the fourfold table Chi-square test,the result showed that the difference has no statistically significance?X²=3.8083,P=0.0510?.2.4 The improvement rate of drinkers and non-drinkers were compared by the fourfold table Chi-square test,the result showed that the difference has statistically significance?X²=12.6479,P=0.0004?.2.5 The improvement rate of the three disease course groups were compared by the Chi-square test,the result showed that the difference has statistically significance?X²=18.2148,P=0.0001?.2.6 The improvement rate of the patients with space occupation lesion in spinal canal and the patients without space occupation lesion were compared by the fourfold table Chi-square test,the result showed that the difference has statistically significance?X²=33.1764,P<0.0001?.2.7 The improvement rate of the patients with spina bifida and the patients without were compared by the fourfold table Chi-square test,the result showed that the difference has no statistically significance?X²=0.4185,P=0.5177?.2.8 The improvement rate of scoliosis patients and patients without scoliosis were compared by the fourfold table Chi-square test,the result showed that the difference has no statistically significance?X²=0.3830,P=0.5360?.3.The regression equationSet improvement rate,age group,disease course group,space occupation lesion in spinal canal,drinking respectively as P,X₁,X₂,X₃,X4,then:Logistic?P?=-4.8669+0.8595X₁+0.8245X₂+2.6177X₃+1.3247X₄Conclusions1.Age,disease course,spinal canal occupation and drinking are significant factors that influence the improvement rate of adult tethered cord syndrome after surgery.2.Regression model established in this study may provide a relatively simple method to predict the improvement rate of adult tethered cord surgery,which may assist neurosurgeons to make clinical decision.