TETHERED CORD SYNDROME IN ADULTS: EXPERIENCE OF 50 PATIENTS

Abstract

Background and Aim: Tethered cord syndrome (TCS) encompasses a range of neurological, urological, and orthopedic symptoms and findings resulting from spinal cord malformations. Majority of cases are associated with spinal dysraphism. The clinical presentations vary depending on the individual's age and variation in underlying pathological condition with the most common manifestations encompassing pain, skin-related signs, orthopedic deformities, and neurological deficits. The objective of this study was to investigate the adult patients diagnosed with TCS.

Patients and Methods: This retrospective study was conducted on 50 TCS patients in the Department of Neurosurgery, Mardan Medical Complex, Mardan - Pakistan from March 2020 to April 2023.  Individuals aged >18 years diagnosed of tethered cord syndrome were enrolled. The study investigated the occurrence and manifestations of various types of spinal dysraphism, as well as the untreated late-presenting cases' natural progression.

Results: The overall mean age was 32.64±4.8 years with an age range 18 to 70 years. There were 16 (32%) male and 34 (68%) females. Back-Leg pain was the prevalent reason for presentation of tethered cord syndrome in n=30 (60%) cases followed by urological complaint n=10 (20%), skin abnormalities 4 (8.0%), Orthopedic abnormalities 3 (6.0%), Numbness-Contraction 2 (4.0%), and neck-arm pain 1 (2.0%). The incidence of spinal dysraphism associated with TCS such as lipomeningomyelocele, TCS secondary to myelomeningocele, dermal sinus, diastematomyelia, meningocele, and thick filum terminale was 16 (32%), 12 (24%), 8 (16%), 6 (12%), 5 (10%), and 3 (6%) respectively.

Conclusion: The present study found that TCS patients should be promptly shifted for the assessment and treatment shortly after diagnosis. This is crucial because without treatment, they are at risk of experiencing progressive neurological deficits.