Electrophysiological and urodynamic studies to monitor surgical outcome in children with tethered spinal cords

Muscle Nerve. 1995 Dec;18(12):1373-7. doi: 10.1002/mus.880181205.


Children with myelodysplasia often develop tethering of their spinal cord within 2-3 years after correction of their initial birth defect, leading to either neurological or urological dysfunction. Surveillance of these children includes electrophysiologic/urodynamic (EMG/UDS) studies to monitor improvement or deterioration of their neurological function. We reviewed 39 patients who underwent surgical untethering from 1979 to 1994 to determine whether postoperative EMG/UDS studies were useful in assessing outcome after surgery. All patients had a complete neurologic examination and an EMG/UDS prior to and 3 months after surgery. Twenty patients (51%) showed improvement in their EMG/UDS study after untethering, 15 (39%) demonstrated no significant change, and 4 (10%) showed deterioration. Improvement consisted of either return of previously absent motor units, return of sacral reflexes, or improved bladder dynamics. In a further 3 patients, subsequent deterioration on serial postoperative EMG/UDS testing was the first indication of recurrent tethering. We conclude that serial EMG/UDS evaluation in patients at risk for tethering of the spinal cord may serve as a useful adjunct to close clinical observation.

MeSH terms

  • Child
  • Child, Preschool
  • Electromyography
  • Electrophysiology
  • Female
  • Humans
  • Male
  • Neural Tube Defects / physiopathology*
  • Neural Tube Defects / surgery
  • Neurologic Examination
  • Recurrence
  • Spinal Cord / physiopathology*
  • Treatment Outcome
  • Urinary Bladder / physiopathology*
  • Urodynamics