Effects of microsurgery for lipoma tethered cord syndrome: report of 611 cases

Abstract

Objective To study the therapeutic effects of microsurgery for lipoma tethered cord syndrome.Method The clinical data of 611 patients with lipoma tethered cord syndrome were studied.The examination in nervous system and MRI were conducted.The microsurgical treatment of lipoma tethered cord syndrome was performed in all cases and the therapeutic effectiveness after operation was analyzed according to Hoffman grading system,Kirollos grading system,urodynamical examination and electrophysiological examination.Results According to Hoffman grading system,87 patients were asymptomatic,289 mild,214 moderate and 21 severe.The degree of untethering was based on Kirollos grading system:Grade Ⅰ in 587 cases( 96.0％ ),Grade Ⅱ in 16 ( 2.6％ ) and Grade Ⅲ in 8 ( 1.3％ ).Recent curative effectiveness in 611 patients was recorded,among them 89 cases ( 14.6％ ) excellent,381 ( 62.4％ ) effective,136 ( 22.3 ％ ) not changed and 5 (0.98％ )aggravated.There were significant differences in urodynamical examination and electrophysiological examination between preoperation and postoperation.Conclusions Tethered cord syndrome should be treated as soon as possible by microsurgery.The clinical practice of urodynamics and neuroelectricity physiology may be helpful for evaluation of postoperative effects. Key words: Neural tube defects ; Lipoma; Tethered cord syndrome; Microsurgery ; Electropysiology; Urodynamics