Comprehensive analysis of the clinical and urodynamic outcomes of secondary tethered spinal cord before and after spinal cord untethering

Patients with secondary TSC are expected to have progression of their symptoms over time if not untethered. From here comes the importance of closely performing clinical/UDS evaluation to pick-up changes early before they progress. Surprisingly, clinical outcomes after SCU with detailed description of the auxiliary management are sparse in the literature. Most studies focus on UDS outcomes. We provided in the current study a detailed discussion of the clinical outcomes, auxiliary-managements used to achieve continence, and the UDS outcomes. Careful periodic clinical/UDS evaluation is recommended for early pick-up of changes suggestive of TSC. SCU could improve existing symptoms, and prevent worsening or development of new symptoms. UDS parameters that showed most improvement were intravesical pressure at TCBC and bladder compliance.Table. Urodynamic outcomes.ParameterMedianRangep-valuePercentage of change of EBC after SCU10.55-36.80.376Percentage of change of actual bladder capacity after SCU12.4−37.7 to 279.4Pressure at TCBC before SCU (cmH2O)359-920.009Pressure at TCBC after SCU (cmH2O)257-77DLPP before SCU (cmH2O)5114.5-860.05DLPP after SCU (cmH2O)2811.3-79Compliance at TCBC before SCU (ml/cmH2O)5.51.7-45.10.01Compliance at TCBC after SCU (ml/cmH2O)6.91.4-28Compliance at 75% capacity before SCU (ml/cmH2O)6.72-50.60.044Compliance at 75% capacity after SCU (ml/cmH2O)10.53-59.5