A retrospective analysis of patients with midline closure defects

Tethered cord syndrome (TCS) is a congenital clinical entity associated with neural tube closure defects and characterized by neurological, urological, and orthopedic manifestations. The present study aimed to evaluate the demographic, clinical, and radiological characteristics of patients who underwent surgical treatment for tethered cord syndrome. This retrospective study included 121 patients who were operated on with a diagnosis of tethered cord syndrome at the Department of Neurosurgery, Manisa Celal Bayar University Research and Training Hospital, between January 2015 and October 2025. Demographic data, presenting symptoms, neurological examination findings, radiological imaging results, postoperative complications, and follow-up data were reviewed from medical records. Of the patients, 72 were female and 49 were male; 63 were in the pediatric age group and 58 were adults. The most common presenting complaints were pain and urological symptoms. Radiological evaluation most frequently revealed a thickened and/or fatty filum terminale, low-lying conus medullaris, and syringomyelia. Notably, despite normal neurological examination findings in a considerable proportion of patients, radiological abnormalities consistent with tethered cord syndrome were detected. Postoperative complications were mostly transient, with cerebrospinal fluid leakage being the most common. Although tethered cord syndrome is more commonly diagnosed during childhood, delayed diagnosis extending into adulthood may occur due to overlooked cutaneous, orthopedic, and urological findings. Early diagnosis and appropriate surgical intervention are crucial in preventing irreversible neurological and urological deficits.