Nazar Hussain, Wakeel Ahmad Haral, Muhammad Akmal Hussain, Inam Ullah Asghar, Tariq Ahmad.
Surgical Outcome of Tethered Cord Syndrome.
Annals Punjab Med Coll Jan ;9(3):151-5.

Objective: Surgical Outcome of tethered cord syndrome. Study Design: Retrospective descriptive. Period and Place of study: Neurosurgery Department Allied Hospital Faisalabad   over 6 months from October 1, 2014 to March 28, 2015. Materials and Methods: Forty patients   were selected at Neurosurgical Department, Allied Hospital, Faisalabad with age ranging from 2 months to 27 years(average 2.58  years). These were assessed clinically and their orthopedic and urological aspects were also assessed.   MRI of relevant area was advised. Counselling was done regarding surgery under general anesthesia and its outcome. Laminectomy or laminotomy was done. Cord was detethered from its attachments from dura, and, in case of lipomeningocele, from its extradural component. In case of   diastometomyelia, bonyspur was extirpated and dura- plasty was done. Tight filum terminale was divided. Surgery was done using microsurgery techniques. Postoperative assessment was done immediately at the time of discharge, at 6 and 12 months. Results: A total of 40 patients, M:F ratio was5:3.    Average age was 2.58   years. Age was ranging from 2 months to 27 years. Power improved in 44 % to grade 5/5 and 37% in grade 4/5 at one year. There was 65 % improvement in anal sphincters and 71% improvement in urinary sphincters at one year. Conclusion: Our clinical and neurological evaluation showed satisfactory outcome after surgery, particularly when performed before the onset of irreversible deficit. Neurological status prior to surgery has profound impact on the   outcome. 

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