Is Homogeneous Spinal Cord Shortening and Axial Decompression (HSAD) Superior to Adults in The Treatment of Tethered Syndrome in Children

Objective: Childhood spinal cord syndrome is a refractory and intractable disease, which gradually worsens with developmental symptoms. The purpose of this study was to evaluate the long-term surgical effects of HSAD in the treatment of tethered cord syndrome in children and adults. Methods: : 50 Patients receiving HSAD tethered from January 2011 to September 2014 included in this study. At least 5 years after follow-up, imaging and clinical data collection. JOA score, VAS score, waist and leg dysfunction index (ODI) score were used to evaluate the patient's neurological function and pain improvement. ICI-Q-SF score, urodynamics, and residual urine volume (B-ultrasound) are used to assess urinary function. The Rintala score is used to assess stool function. Results: : A total of 50 patients were enrolled and the patients were divided into children group (n=26) and adult group(n=24). JOA improvement rate in children group (54.95%±14.14%vs34.95%±11.82%), maximum urine flow rate improvement value (4.87±5.49vs1.40±1.88) and residual urine volume improvement value (118.46±39.11vs62 .83±59.28) was greater than the adult group, and the postoperative ICIQ-SF score (6.21 ± 4.85vs7.75 ±4.23) was lower than that of the adult group (P <0.05). Conclusion: HSAD can achieve good clinical effects in treating children and adults with tether syndrome. In the long run, it may benefit urinary function, especially in children.