Management of adult tethered cord syndrome: our experience and review of literature

Abstract

Background: Tethered cord syndrome (TCS) is a complex clinicopathologic entity, mostly described in children with limited number of studies describing in adults. This unique and rare subgroup of patients presents with characteristic features of TCS, but unlike children, pain is a predominant clinical symptom.

Materials and methods: Case records of 24 patients aged ≥16 years who had undergone surgery with a diagnosis of TCS between 2001 and 2011 were reviewed. Patients who have underwent surgery earlier for tethered cord or for diastematomyelia/spinal dysraphism and patients who had radiological evidence of tethering elements like lipoma of the cord on magnetic resonance imaging (MRI) were excluded from the study.

Results: Low backache was the most common presenting symptom. At the time of final follow-up, 15 (83.3%) patients had shown improvement in backache. Weakness improved by at least one grade in seven (77.8%) patients. Bladder symptoms improved in six (50%) patients.

Conclusion: In case of symptomatic patient with low-lying cord, detethering is an advisable option.