Incidence and Factors of Tethering After Sectioning the Filum Terminale.

Abstract

Aim: To assess the incidence of retethering in patients who underwent surgery for tethered cord in our clinic.

Material and methods: We included patients who underwent surgical intervention for tethered cord in our clinic between 2010 and 2020, and were subsequently diagnosed with retethering during follow-up. Only those with available postoperative clinical follow-up data were included. The study analyzed the timing of surgery, gender, presenting symptoms, intraoperative findings, postoperative outcomes?including complications?and follow-up duration.

Results: Over a 10-year period, 59 patients underwent surgery for tethered cord. Among them, 11 patients required reoperation for retethering at a median age of 5 years. The median interval between the initial and retethering surgeries was 47.6±43.20 months. Two patients were asymptomatic at the time of their initial surgery. Among the 11 patients with retethering, 3 (27.2%) presented with bladder or bowel dysfunction, 4 (36.3%) with neuro-orthopedic symptoms, and 4 (36.3%) with pain. Two patients experienced a second episode of retethering and required a third surgery, which occurred approximately 2 years after the second procedure.

Conclusion: The risk of retethering should be carefully monitored in patients with tethered cord, particularly during growth periods.