• Haibo Wang, Tao Xu, Jingchuan Sun, Yuan Wang, Kaiqiang Sun, Ximing Xu, Bin Zhang, Yongfei Guo, and Jiangang Shi.
• Department of Orthopedic Surgery, Spine Center, Changzheng Hospital, Second Military Medical University, Shanghai, China.
• World Neurosurg. 2019 Apr 1; 124: e702e706e702-e706.

ObjectiveTo evaluate surgical outcomes of homogeneous spinal-shortening axial decompression (HSAD) for reoperation in pediatric patients with tethered cord syndrome.MethodsTwenty consecutive pediatric patients (≤18 years old, 7 boys, 13 girls) who underwent HSAD after untethering surgery between June 2012 and May 2015 were included. The Japanese Orthopaedic Association score and visual analog scale were used to evaluate preoperative and postoperative neurologic function and pain. The International Consultation on Incontinence Questionnaire-Short Form and urodynamics were used to evaluate urinary function. The Rintala score was used to evaluate stool function.ResultsMean age of patients was 13.4 ± 3.6 years (range, 7-18 years). The mean duration of follow-up was 31.2 ± 12.7 months (range, 12-48 months). The Japanese Orthopaedic Association score was increased from 13.31 ± 4.03 preoperatively to 19.15 ± 4.17 at final follow-up (P < 0.01). The visual analog scale score was decreased from 5.25 ± 1.78 preoperatively to 2.21 ± 1.63 at final follow-up (P < 0.01). 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). All urodynamics parameters improved compared with before the operation. The Rintala score improved from 5.26 ± 3.45 preoperatively to 12.32 ± 3.43 at final follow-up (P < 0.01).ConclusionsOutcomes of HSAD for revision surgery of tethered cord syndrome were satisfactory. HSAD improved neurologic function of patients significantly. HSAD could become an alternative surgical treatment of reoperation for tethered cord syndrome.Copyright © 2019 Elsevier Inc. All rights reserved.

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