• Haibo Wang, Jingchuan Sun, Yuan Wang, Kaiqiang Sun, Ximing Xu, Bin Zhang, and Jiangang Shi.
• Department of Orthopedic Surgery, Spine Center, Changzheng Hospital, Second Military Medical University, Shanghai, China.
• World Neurosurg. 2019 Jul 1; 127: e517-e522.

ObjectiveTethered cord syndrome is a rare and intractable disease. The aim of this study was to investigate surgical outcome of homogeneous spinal-shortening axial decompression (HSAD) for tethered cord syndrome through a minimum 3-year follow-up.MethodsPatients who underwent HSAD for tethered cord syndrome in our institution between May 2011 and July 2015 were included in this study. After a minimum 3-year follow-up, radiologic and clinical data were collected. Surgical outcome was evaluated with Japanese Orthopaedic Association, visual analog scale, International Consultation on Incontinence Questionnaire-Short Form, and Rintala scores and urodynamics.ResultsThe study included 64 patients (28 men and 36 women) with a mean age of 35.7 ± 18.1 years. Significant improvement of visual analog scale and Japanese Orthopaedic Association scores was noted postoperatively and at a minimum 3-year follow-up. At the final follow-up, Japanese Orthopaedic Association and visual analog scale scores in all patients were improved compared with preoperatively. The International Consultation on Incontinence Questionnaire-Short Form score was decreased from 14.94 ± 4.15 preoperatively to 7.63 ± 4.40 at final follow-up (P < 0.01). Rintala score was improved from 5.26 ± 3.45 preoperatively to 12.32 ± 3.43 at final follow-up (P < 0.01). All urodynamic parameters improved compared with preoperatively.ConclusionsHSAD was effective and safe. The results were satisfactory with a minimum 3-year follow-up. HSAD could be an alternative surgical treatment of TCS.Copyright © 2019 Elsevier Inc. All rights reserved.

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