Surgical treatment of tethered cord syndrome with sacral canal cysts: Analysis of 13 cases

Abstract

TCS is a clinical manifestation of abnormal stretch of spinal cord, which needs to be solved urgently. To review and summarize the most recent surgical cases in our department involving a rare disease (tethered cord syndrome (TCS) with sacral canal cyst). From December 2015 to February 2018, thirteen patients with TCS and a sacral canal cyst, ranging in age from 8 to 53 years, were enrolled. There were eight males and five females in the group. A spine X-ray, CT, MR, lower extremity evoked potential, residual urine, and urodynamics were performed in addition to the standard preoperative examination. All patients underwent microsurgery while being electrophysiologically monitored. During the operation, Kirollos and Van-Hille graded the degree of tethered cord release, as well as Hoffman's neurological functional grading to assess efficacy and lumbosacral MRI observation of the sacral canal cyst recurrence. There were no deaths. The TCS was completely released during the operation, and the sacral canal cyst did not recur. Except for one patient who experienced increased postoperative symptoms, the symptoms or signs of the remaining patients improved to varying degrees, according to the Hoffman neurological function classification. In sacral canal cyst patients, intraoperative use of a surgical microscope and electrophysiological nerve function monitoring can effectively reduce spinal cord and nerve damage and improve surgical safety.