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March 1957

Restitution of Continence in Spina Bifida: The Tethered Cord Syndrome

Author Affiliations

Galveston, Texas
From the Department of Surgery, Divisions of Urology (Drs. Thompson and Hooks) and Neurosurgery (Dr. Jackson), University of Texas Medical Branch.

AMA Arch Surg. 1957;74(3):338-344. doi:10.1001/archsurg.1957.01280090036007

Persons born with any of the types of the congenital anomaly of spina bifida can present urological problems similar to those seen in paraplegics, where the etiology may be tumor, trauma, or infection. Although many varieties of spina bifida exist, it is in the more extensive types, meningomyelocele and myelocele, that the neurologic deficit seriously compromise vesical and rectal continence. Despite orthopedic and neurosurgical successes in the early repair of such deformities and in rehabilitative therapy, little if any advance has been noted consequent to therapeutic attacks upon urinary and fecal incontinence. There has been additionally, in many instances, a gradual deterioration of the upper urinary tracts, a waning of function, and a progressive dilatation of collecting components. In the face of the seeming hopelessness of the urological situation in these patients, reevaluation of the occasional startling success attending sacral exploration of meningomyeloceles repaired at birth (wherein denudation of the

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