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The most common symptoms include pain, motor or sensory dysfunction, and urologic deficits. Although TCS is common in children, there is a significant heterogeneity in outcomes reporting. We systematically reviewed surgical indications and postoperative outcomes to assess the need for a grading\/classification system.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>PubMed and EMBASE searches identified pediatric TCS literature published between 1950 and 2023. Studies reporting surgical interventions,\u2009\u2265\u20096-month follow-up, and\u2009\u2265\u20095 patients were included.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Fifty-five studies representing 3798 patients were included. The most commonly reported non-urologic symptoms were nonspecific lower-extremity motor disturbances (36.4% of studies), lower-extremity\/back pain (32.7%), nonspecific lower-extremity sensory disturbances (29.1%), gait abnormalities (29.1%), and nonspecific bowel dysfunction\/fecal incontinence (25.5%). Urologic symptoms were most commonly reported as nonspecific complaints (40.0%). After detethering surgery, retethering was the most widely reported non-urologic outcome (40.0%), followed by other nonspecific findings: motor deficits (32.7%), lower-extremity\/back\/perianal pain (18.2%), gait\/ambulation function (18.2%), sensory deficits (12.7%), and bowel deficits\/fecal incontinence (12.7%). Commonly reported urologic outcomes included nonspecific bladder\/urinary deficits (27.3%), bladder capacity (20.0%), bladder compliance (18.2%), urinary incontinence\/enuresis\/neurogenic bladder (18.2%), and nonspecific urodynamics\/urodynamics score change (16.4%).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>TCS surgical literature is highly variable regarding surgical indications and reporting of postsurgical outcomes. The lack of common data elements and consistent quantitative measures inhibits higher-level analysis. The development and validation of a standardized outcomes measurement tool\u2014ideally encompassing both patient-reported outcome and objective measures\u2014would significantly benefit future TCS research and surgical management.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00381-023-06246-y","type":"journal-article","created":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T04:08:53Z","timestamp":1702267733000},"page":"1111-1120","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Disparities in indications and outcomes reporting for pediatric tethered cord surgery: The need for a standardized outcome assessment tool"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7894-2941","authenticated-orcid":false,"given":"Matthew C.","family":"Findlay","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9751-3724","authenticated-orcid":false,"given":"Samuel","family":"Tenhoeve","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7605-3271","authenticated-orcid":false,"given":"Skyler A.","family":"Terry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9896-6967","authenticated-orcid":false,"given":"Rajiv R.","family":"Iyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8602-0931","authenticated-orcid":false,"given":"Douglas L.","family":"Brockmeyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6221-7406","authenticated-orcid":false,"given":"Michael P.","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3634-2312","authenticated-orcid":false,"given":"John R. 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