Two cases of adult tethered cord syndrome with surgical treatment

We report two cases of adult tethered cord syndrome alleviated by untethering surgery. Case 1 was a 35 year-old female who complained of incontinence while exercising. Radiograph revealed spinal disraphism below the L5 level. In addition, magnetic resonance imaging (MRI) showed low placed conus medullaris at the levels of S2 and sacral intradural lipoma. Further urodynamic studies demonstrated normal sphincteric function and autonomous bladder. Diagnosis resulted in the decision to perform an untethering operation. The patient had increased bladder compliance after surgery for untethering and has continued to be continent 16 months post-operatively. Case 2 was a 27-year old female who complained of apprehension to void and straining during urination. Radiograph demonstrated spinal disraphism below the S2 level and MRI revealed low placed conus medullaris at the level of S5 and sacral intradural lipoma. Urodynamic examination verified normal sphincteric function and autonomous bladder. After complete diagnosis, an untethering operation was performed. Post-operatively, bladder compliance and urinary sensation normalized. Furthermore, the patient spontaneously delivered a baby 3 years after having the untethering operation.