Clinical evaluation of an innovative operative procedure in the treatment of the tethered cord syndrome.

BACKGROUND CONTEXT: The tethered cord syndrome (TCS) characterized by urination dysfunction has long been a worldwide clinical problem, of which clinical effects remains controversial.

PURPOSE: The objective of this study was to evaluate the clinical effects of an innovative surgical method for the treatment of TCS.

STUDY DESIGN: This is a retrospective clinical study.

PATIENT SAMPLE: There were 15 patients included in this study.

OUTCOME MEASURES: The visual analog scale (VAS) and the Japanese Orthopaedic Association (JOA) scores were evaluated. The incidence of complications after surgery was also analyzed.

MATERIALS AND METHODS: A total of 15 patients including 9 men and 6 women with TCS underwent homogeneous spinal-shortening axial decompression (HSAD) from September 2011 to February 2015. The average age at the time of surgery was 38.1±17.7 years. The average postoperative follow-up period was 21.5±7.5 months. The VAS and JOA scores were used to evaluate the clinical effects of the new operational procedure. In addition, the incidence of complications was also recorded and analyzed.

RESULTS: The VAS scores decreased from 3.93±2.52 to 1.80±1.21 at the final follow-up after surgery with a significant statistical difference (p=.006). The JOA scores also significantly increased from 9.93±3.43 to 21.20±4.18 at the final follow-up (p<.001). Fourteen cases (93.3%) with bladder dysfunction and 7 cases with sensory dysfunction of the lower limbs (87.5%) had a significant improvement postoperatively. Complications such as infection, pulmonary embolism, nerve injury, and broken rod were not observed during the follow-up period.

CONCLUSIONS: The operation of HSAD was an effective and safe surgical method for TCS, which can achieve direct decompression of the tethered spinal cord.