Tethered Cord Syndrome and Split Cord Malformation: A Retrospective Review with Advanced Surgical Technique

Abstract Tethered cord syndrome is a rare condition resulting from compression due to congenital anomalies. This study aims to report surgical findings and outcomes in managing tethered cord syndrome. We retrospectively studied 48 patients diagnosed between October 2009 and December 2017. Demographic, clinical, radiological, and surgical details were reviewed, including neurological, urological, and orthopedic findings. 72.9% pediatric, and 27.1% adults. Neurologic, skin, and orthopedic manifestations were observed in 35%, 31%, and 48% of patients. Lower limb weakness was most common (94%). 44% had a split cord, with type I more common in pediatric patients and type II more common in adults. All underwent surgical intervention, showing significant long-term improvement in neurological, orthopedic, and urological symptoms. Only 8% had moderate improvement; two cases required redoing untethering and adhesiolysis. Timely surgical intervention, including untethering, decompression, and anomaly resection, yields significant neurological outcomes in tethered cord syndrome management.