{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:26:33Z","timestamp":1787030793773,"version":"build-2736575974"},"reference-count":14,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>It is controversial whether surgical correction of tethered spinal cord in non\u2010myelomeningocele tethered cord patients results in reversal versus stabilization of urologic (GU), gastrointestinal (GI), and musculoskeletal (MSK) symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine factors associated with clinical improvement in symptoms after spinal cord de\u2010tethering, and evaluate whether pre\u2010operative urodynamic testing predicts post\u2010operative clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>213 non\u2010myelomeningocele children who underwent primary spinal cord de\u2010tethering at a quaternary children's hospital from 2012 to 2020 were retrospectively reviewed. Age at surgery, gender, and presence of GU symptoms, constipation, MSK symptoms, and urodynamic studies were collected. Pre\u2010operative symptoms and demographics were compared between patients with and without resolution of GU symptoms after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean age at surgery was 5.36 years, 48% were female, and mean length of follow up was 1.8 years. Before surgery, 133\/213 (62%) experienced a GU symptom. 105\/213 (49%) patients were potty\u2010trained. Of 105 potty\u2010trained patients, 50 (48%) had daytime incontinence and 55 (52%) had nocturnal enuresis. Of 88 potty\u2010trained patients with urinary symptoms, 22 (25%) had resolution of and 59 (67%) had improvement following surgery. Of the 102 with constipation, 45 (44%) had improvement. Of the 116 with musculoskeletal symptoms, 60 (52%) had improvement. Patients with resolution of GU symptoms were younger (4.97 vs. 8 years,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0019). Patients with daytime urinary incontinence (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0119) were less likely to have resolution of GU symptoms. There was no difference in urodynamic findings between patients with and without improvement or resolution of urologic symptoms.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Younger age at de\u2010tethering surgery is associated with improvement in genitourinary symptoms. Preoperative urodynamic studies may not be predictive of postoperative outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nau.70288","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T06:14:01Z","timestamp":1775542441000},"page":"1328-1335","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Symptomatic and Urodynamic Outcomes After Spinal Cord De\u2010Tethering in Primary Tethered Cord Patients"],"prefix":"10.1002","volume":"45","author":[{"given":"Emily A.","family":"Reeson","sequence":"first","affiliation":[{"name":"Creighton University School of Medicine Phoenix Regional Campus Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Didde","sequence":"additional","affiliation":[{"name":"Creighton University School of Medicine Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung Yon","family":"Lin","sequence":"additional","affiliation":[{"name":"Mayo Clinic Arizona Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Nelson","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9610-1972","authenticated-orcid":false,"given":"Daniel","family":"Salevitz","sequence":"additional","affiliation":[{"name":"Mayo Clinic Arizona Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Tolan","sequence":"additional","affiliation":[{"name":"Creighton University School of Medicine Phoenix Regional Campus Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer S.","family":"Ronecker","sequence":"additional","affiliation":[{"name":"Phoenix Children's Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gwen M.","family":"Grimsby","sequence":"additional","affiliation":[{"name":"Phoenix Children's Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,6]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-016-3053-y"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.21037\/jss.2019.09.02"},{"key":"e_1_2_11_4_1","unstructured":"Tethered Cord Syndrome. National Organization for Rare Disorders; Accessed February 27 2023 https:\/\/rarediseases.org\/rare-diseases\/tethered-cord-syndrome\/."},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2016.02.012"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2014.02.2549"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2014.10.008"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.22783"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11934-015-0550-6"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1996.85.4.0555"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2006.03.116"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2014.06.008"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000290902.07943.E6"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2015.09.082"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.23382"}],"container-title":["Neurourology and Urodynamics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.70288","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/nau.70288","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.70288","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:24:12Z","timestamp":1787027052000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/nau.70288"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,6]]},"references-count":14,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/nau.70288"],"URL":"https:\/\/doi.org\/10.1002\/nau.70288","archive":["Portico"],"relation":{},"ISSN":["0733-2467","1520-6777"],"issn-type":[{"value":"0733-2467","type":"print"},{"value":"1520-6777","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,6]]},"assertion":[{"value":"2025-01-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}