A Randomized Controlled Trial for Surgical Treatment of Recurrent Adult Tethered Cord Syndrome

Inclusion Criteria: * Patients who have previously detethering surgery for primary tethered cord syndrome, including filum terminale untethering, dermoid or lipoma resection, with a recurrence of spinal cord tethering postoperatively. * The presence of related clinical symptoms, including bowel and bladder dysfunction, sensory impairment, numbness, pain in the lower limbs, perineal or buttock area, motor dysfunction of the lower limbs, muscle weakness, and sexual dysfunction. * Primary diagnosis of a thickened filum terminale, low-lying conus medullaris, meningocele, lipoma, dermoid, or spina bifida. Exclusion Criteria: * Patients with severe scoliosis at the thoracolumbar junction. * Patients with severe osteoporosis or other conditions that contraindicate internal fixation. * Patients with severe pressure ulcers or skin breakdown in the lumbar or thoracic region. * Patients with severe systemic diseases that cannot tolerate surgery. * Other cases deemed unsuitable for inclusion following evaluation by professional neurosurgeons.