Our Surgical Treatment Results in Adult Tethered Cord Syndrome: An Experience of 9 Cases

Abstract

Objective:The aim of this study was to present the results of surgical treatment along with demographic and clinical features in cases with tethered spinal cord syndrome seen in adulthood. Method: We retrospectively evaluated 73 cases who underwent tethered cord release operations with the diagnosis of tethered cord syndrome between 2004 and 2015 in our clinic. The mean follow-up period was 21.7 (3-63) months. Adult cases consisted of 5 female and 4 male patients aged between 18-55 years. Clinical and radiological characteristics of the patients and follow-up data related to the surgical treatment were recorded. Pain and neurological findings were graded using the scoring system proposed by Klekamp et al. Results: Nine patients had complaints of back and/or leg pain, two patients had gait ataxia and three patients had bladder dysfunction. Only one patient had a loss of muscle strength. There were cutaneous stigmata in a total of three patients: These were two dermal sinus tracts, one thoracic dermatomal hypertrichosis. Four patients had scoliosis, 4 had syringomyelia and 3 had split cord malformation. The level of conus medullaris was L3 in one patient, L4 in 3 patients, L5 in 2 patients, and S1 in one patient. All patients underwent surgical detethering. Most of the patients reported a decrease in their pain levels. However, sensory dysfunction and sphincter problems remained unresolved. Conclusion:The main difference between adult cases compared to pediatric cases was related to symptomatology. The pain was the cardinal symptom in almost all cases. While the surgery was effective to diminish pain, it was not effective in resolution of neurological deficits.