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Introduction: Patients with tethered cord syndrome become symptomatic during the period of their growth spurt. Apart from progressive foot and spinal deformities, patients also develop motor deficits and bladder and bowel dysfunction. Early diagnosis and adequate release of the tethered cord are indispensable to successful management. Objectives:  To study the trends in the neurological outcome after surgical treatment of cord tethering in pediatric population. Methodology: Study was carried out from January 2018 to December 2019 at neurosurgery department, Fauji Foundation Hospital Rawalpindi. Thirty-five patients were included in the study who fulfilled the inclusion criteria. Results: The average age of the patients at the time of the intervention was 11 years. There were 21 females (60.0%) and 14 males (40.0%). The distribution of neurological status improvement tells improvement in back pain in 28 patients (80%), improvement in motor function in 14 patients (40%), and improvement in urinary incontinence in 7 patients (20%). Conclusion: This study concludes that back ache improves significantly after surgery while urinary incontinence is the least benefited symptom. Untethering along with the rehabilitation also helps majority of the patients with motor deficit. The ratio of symptomatic relief was best for backache and motor function and then improvement in the urinary control.

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