Tethered cord syndrome: clinical signs and results of operation in 42 patients with spina bifida aperta and occulta.

Abstract

The results of tethered spinal cord operations in 42 patients were evaluated. Over a period of 10 years, 20 spina bifida occulta (S.B.O.) and 22 spina bifida aperta (S.B.A.) patients were operated. In the S.B.O. group 6 patients were operated when young in order to prevent neurological deterioration. With a mean follow-up of 3 years they developed no new neurological symptoms. The clinical symptoms and the age at which the neurological deterioration occurred was quite similar in the S.B.O. and S.B.A. patients. Motor dysfunction and pain in back and/or legs were the most frequent symptoms. The postoperative complication rate was low. The purpose of surgery was to stop further neurological deterioration. The operative results were slightly better in the S.B.A. group than with the S.B.O. group. In both groups of patients it was evident that operation at an older age after a long period of complaints was associated with less favourable postoperative results. The surgical treatment of a tethered spinal cord syndrome in patients with spina bifida aperta is no more risk than an operation in spina bifida occulta patients.