Clinical Characteristics and Functional Outcomes After Surgery for Spinal Dysraphism: A Retrospective Cohort Study

IntroductionSpinal dysraphism includes heterogeneous congenital lesions that may affect motor, bladder, and bowel function.This study described the clinical spectrum, perioperative events, and functional outcomes after surgery. MethodsWe retrospectively studied 276 patients who underwent surgery for spinal dysraphism.Neurological function was recorded using the modified McCormick grade.Preoperative and postoperative grades were compared with the Wilcoxon signed-rank test.Simple group comparisons explored factors associated with improvement.Categorical variables were compared with the chi-square or Fisher's exact test, and continuous variables with the Mann-Whitney U test. ResultsThe median age was 2.3 years (interquartile range, 0.73-5.0),and 148 patients (53.6%) were male.Motor weakness was present in 212 (76.8%), bladder involvement in 146 (52.9%), and bowel involvement in 62 (22.5%).The median modified McCormick grade was 4 before surgery and 3 after surgery (P < 0.001).Functional grade improved in 108 patients (39.1%), remained unchanged in 162 (58.7%), and worsened in six (2.2%).Immediate postoperative complications occurred in 29 patients (10.5%).Improvement was associated with lower preoperative motor power, greater preoperative functional disability, selected caudal dysraphic phenotypes, sac repair, and detethering in unadjusted comparisons.Bladder involvement did not change significantly after surgery (P = 0.625). ConclusionMost patients had stable or improved postoperative functional grades.Because the cohort was retrospective and anatomically heterogeneous, the observed associations should be considered descriptive rather than predictive across diverse lesions and operative approaches.Standardized long-term neurological and urological follow-up is needed.