TETHERED CORD SYNDROME IN ADULTS - REPORT ON 25 CASES

A series of 25 adult patients surgically treated for a tethered cord s yndrome is reported. Preoperatively 19 patients presented with a senso rimotor deficit in their lower limbs, 17 with sphincter disturbances, 12 with pain and/or neuroorthopedic symptoms and 9 with cutaneous lumb ar anomalies. At surgery, an isolated anomaly (lipoma, anomalous or ad herent Filum terminale) was disclosed in 18 patients. In the remaining 7, a more complex form of dysraphism was disclosed. Follow-up ranges from 3 months to 20 years (mean : 6,5 years). Ten patients improved, 6 were stabilized and 9 showed continuous worsening. The best results w ere obtained in patients in whom the cord tethering resulted from an a nomalous filum terminale. Results were significantly worse in patients suffering long standing symptomatology and showing either radiologica lly or surgically mixed mechanisms of cord tethering. Early surgical c orrection should be idealy undertaken in patients suffering from minor neurological deficits and in whom magnetic resonance imaging illustra tes a low conus medullaris attached by a short thickened filum termina le.