• Ximing Xu, Kaiqiang Sun, Jingchuan Sun, Yuan Wang, Jian Zhu, Xiaoqiu Yuan, Chenglong Ji, Yongfei Guo, and Jiangang Shi.
• Department of Orthopedic Surgery, Spine Center, Changzheng Hospital, Navy Medical University (Second Military Medical University), No 415 Fengyang Road, Shanghai, 200003, People's Republic of China.
• Eur Spine J. 2022 Jan 1; 31 (1): 190-196.

ObjectiveTo evaluate the effect of homogeneous spinal-shortening axial decompression procedure (HSAD) on bladder function in patients with spina bifida tethered syndrome.Methods And MaterialsPatients with tethered spinal cord syndrome were collected prospectively, and all patients were treated with lumbar HSAD. Patients' urodynamic evaluation mainly included detrusor function, sphincter function, sphincter coordination (Ig TLR, ratio of tension and loose of urethral sphincter), and bladder compliance. Meanwhile, all patients were followed up with ICI-Q-SF, SF-12, and Rantala scores.ResultsTwenty-four patients were included, with the average age of 27 ± 16 years. At the final follow-up, patients' detrusor function, sphincter function, sphincter coordination, and bladder compliance, were all improved dramatically (all P < 0.01). The preoperative SF-12 score, ICQ, and Rantala score were [52.16 ± 5.64, 14.11 ± 5.25, 7.84 ± 4.87], whereas the postoperative mean was [33.53 ± 3.53, 9.05 ± 4.89, 15 ± 3.77] (P < 0.01, respectively). According to objective evaluation, 16.7% of them recovered to normal. According to the subjective evaluation, 25% of the patients returned to normal. Only one patient (4.2%) deteriorated. Limitations include none-randomized controlled design and limited patient samples.ConclusionsThe HSAD can significantly restore the bladder function in patients with long-term urinary incontinence.© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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