Volume 30, Issue 7 pp. 1333-1337
Original Clinical Article

Improved symptoms and lifestyle more than 20 years after untethering surgery for primary tethered cord syndrome

Junnosuke Fukui

Corresponding Author

Junnosuke Fukui

Department of Urology, Shinshu University Hospital, Asahimachi Matumotoshi, Naganoken, Japan

Department of Urology, Takeyama Hospital, 3-1-9 Tkeyama Midoriku Yokohama, 399-0005, Japan.Search for more papers by this author
Kuniyoshi Ohotsuka

Kuniyoshi Ohotsuka

Department of Orthopedics, Nagano Rehabilitation Center, Naganoshi, Naganoken, Japan

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Yoshimi Asagai

Yoshimi Asagai

Department of Orthopedics, Shinano Handicapped Children's Hospital, Shimosuwachou, Suwagun, Naganoken, Japan

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First published: 27 May 2011
Citations: 8

Conflicts of interest: none.

Dirk De Ridder led the review process.

Abstract

Aims

Evaluation of the long-term effectiveness of untethering surgery on social adaptations to urinary symptoms at the time of the survey.

Methods

Postoperative analysis of the current activities of daily life implemented as a postal questionnaire survey. Completed questionnaires were returned by 33 of 52 patients with primary tethered cord syndrome (p-TCS) who had undergone untethering surgery more than 20 years ago, including 10 patients with tight filum terminale (TFT) and 23 with cauda equina adhesion syndrome (CEAS).

Results

Long-term follow-up surveys in patients with p-TCS after untethering surgery indicated excellent effects on lower urinary tract symptoms in 9 of 10 patients with TFT, and the progression of symptoms tended to improve or halted in over half of the 23 patients with CEAS. However, one patient with TFT in whom new symptoms of voiding difficulty appeared immediately after surgery and 7 with CEAS showed deterioration of urinary and/or bowel symptoms. Eighteen patients complained of some symptoms caused by lower urinary tract dysfunction after untethering surgery in terms of difficulty in activities of daily life. With the exception of one female p-TCS patient with short stature and low body weight, all data of physical status, as well as educational level, employment, occupational category and marriage statistics were within the normal respective ranges taken from the Japanese census.

Conclusions

Postoperative long-term follow-up survey in patients with p-TCS indicated significant improvement of urological symptoms. However, 55% of patients had some lower urinary tract dysfunction that affected their activities in daily life. Neurourol. Urodynam. 30:1333–1337, 2011. © 2011 Wiley-Liss, Inc.

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