Tethered cord syndrome in patients with myelomeningocele: Presentation of 3 cases, technical note on re-anchoring without dural opening.

BACKGROUND

Following myelomeningocele (MMC) repair, 10-30% of patients develop tethered cord syndrome (TCS). Surgical intervention is critical to reverse the stretching of the spinal cord. Here, we describe a technique for spinal cord untethering without dural opening in these patients.

METHODS

Three patients underwent spinal cord untethering without dural opening. The surgical technique involved reopening the previous incision and dissecting the scar tissue attached to the dura. A Spongostan sponge was inserted, and lateral sutures were placed between the dural sac and the adjacent muscles. Clinical outcomes, imaging findings, and urodynamic results were evaluated postoperatively.

RESULTS

The technique demonstrated positive outcomes in all three cases. Patients showed symptom improvement, better positioning of the spinal cord on imaging studies, and enhanced bladder function on urodynamic evaluations.

CONCLUSION

Spinal cord re-untethering without dural opening may be a viable surgical option for selected patients with MMC, offering favorable outcomes with reduced risk.