The authors have attempted to use a UD scoring system to assess prospectively the need for and effect of surgery to correct a tethered spinal cord in children with lipomyelomeningocele. They have practiced due diligence by carefully applying the score in 29 children to show its efficacy. It appears that children with scores greater than 7 were operated on regardless of whether they had symptoms (although 2 "symptomatic" patients had a score of 6). The results of surgery were improvement in UD score in 7 of 11 symptomatic patients and in all asymptomatic children. However, scores remained above 7 in 3 of the 7 symptomatic patients who improved and in 1 of the asymptomatic patients who were operated on.
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