ABSTRACT
To evaluate the surgical treatment of tethered spinal cord [TSC] in relation to the initial aetiology. Twenty-two patients suffering from TSC underwent untethering surgery fur their lesions between 2005 and 2006. Eleven patients were previously operated on for myelomeningocele [MM] at birth [group I] and 11 had primary TSC associated with skin signs of occult spine dysraphism [group II]. Age range was between 18 months and 11 years. Neurological disability was evaluated as moderate for both groups before surgery, and none of the patients, especially in group I, had complete paralysis. All the selected patients developed urinary dysfunction associated with motor weakness or aggravated their initial clinical status. All patients had preoperative neurological and urine function evaluation, then again at least 2 months following surgery. The follow-up period ranged from 2 months to 1 year. Postoperatively, in group I, 4 patients [36%] had improved urinary and motor functions. Three patients improved only motor function with stable urinary function [total motor improvement 63%]. Two did not show any changes, while 2 patients deteriorated. In group II, 6 patients [54%] improved their urinary and motor conditions after the untethering procedure, 3 patients improved their motor condition with a stable urinary function [total motor improvement 81%] and 2 did not show any changes. It seems that untethering operation may improve the clinical conditions for patients suffering from TSC but results of such a procedure are better in group II than in group I