Spinal cord detethering in children with tethered cord syndrome and Chiari type 1 malformations

Abstract We discuss the association between tethered cord syndrome (TCS) and Chiari type 1 malformation (CM1), and report on the surgical outcomes of children with CM1 and TCS who underwent sectioning of the filum terminale (SFT). The relationship between TCS and CM1 is unclear. A retrospective review of 170 consecutive spinal cord detetherings between 2008 and 2012 was performed. We identified 17 children with CM1 who underwent SFT. Information regarding clinical presentation, radiographic findings, surgical procedures, and clinical outcomes was analyzed. A mean tonsillar herniation of 10.0 mm (range: 5–21) was noted. Children with a fatty or thickened filum terminale demonstrated a greater amount of tonsillar displacement ( p