The tethered spinal cord has undergone organic changes when symptoms appear, and we can't make it return to normal, so we can only correct it properly so that it will not continue to develop. The symptoms of tethered cord syndrome may be caused by the destructive injury of the nervous system, which is usually irreparable, and the treatment only makes the injury not worse. It may also be caused by stimulation or incomplete injury of the nervous system. At this time, surgical treatment may achieve the dual effects of relieving symptoms and preventing the progression of the disease.
Therefore, the fundamental purpose of surgical treatment of tethered cord syndrome is to prevent the disease from continuing to progress, and some patients' lower limb motor and sensory functions, and even defecation and defecation functions may be improved. Usually, the occurrence of defecation dysfunction often indicates a poor prognosis. Surgery can not improve defecation dysfunction, lower limbs and foot deformation, but it may improve pain and incomplete muscle strength decline to some extent. Deformities of lower limbs and feet can be improved by orthopedic surgery. Therefore, many patients with tethered cord syndrome, especially children, need the joint diagnosis and treatment of spinal surgery or neurosurgery, urology and orthopedics.
For patients with tethered cord syndrome with normal defecation function, including those found due to skin changes in lumbosacral region, sensory and motor disorders of lower limbs, we suggest systematic examination, evaluation and surgical treatment as soon as possible; For patients who have already had dysfunction of defecation and urination, surgery should be selected according to their general situation and related examinations. Most of these patients can and need surgery.
When performing surgery on patients, we should implement the concept of minimally invasive surgery, adhere to microsurgery, and cooperate with electrophysiological monitoring when necessary to loosen the tether as thoroughly as possible to avoid nerve injury, reduce re-adhesion and tether, and prevent postoperative wound complications.
Follow-up patients after operation, and give as much guidance as possible to the prevention and treatment of urinary dysfunction, the rehabilitation of lower limb movement and sensation, and the correction of lower limb deformity. We believe that it is not good for patients to only pay attention to tethered surgery and ignore the correct guidance for the continued diagnosis and treatment of these dysfunction.