الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Background: Spinal dysraphism refers to midline abnormalities of the back, from skin to vertebral column. It includes all lesions that are the consequence of incomplete formation of midline structures of the dorsum. It is classified as open form (operta) or closed form (occulta).
Aim of the Work: We aim to discuss urological outcomes of early surgery in occult spinal dysraphism and address information in the literature regarding preoperative work up, timing of intervention, and expectations after surgery.
Patients and Methods: All available research studies addressing the topic e.g. Randomized Controlled Trials, Cohort, Case- control series, and reviews. We will perform a systematic literature review via Pub Med, Cochrane library, EMBASE. The review will be guided by the ’Cochrane systematic review of interventions’ books and Pub med tutorials, under supervision of the director and co-directors mentioned in the beginning of this protocol. Additional studies will be identified by contacting clinical experts and searching bibliographies and abstracts presented at the Egyptian and American society of Neurosurgeons.
Results: A total of 615 citations were retrieved according to our search strategy and review of bibliographies that addressed occult spinal dysraphism topic and spinal cord untethering. One-hundred and forty-four of these studies discussed urinary incontinence in children. Thirty-one of these studies involved urodynamic results. Ten of these studies met the inclusion criteria and were included in the analysis (studies involving adult patients, asymptomatic or other neurological symptoms were excluded). Eight were obtained from Medline via PubMed and two were obtained from manual search and review of bibliographies. These studies were retrieved and reviewed.
Conclusion: The management of Tethered cord syndrome and occult spinal dysraphism remains controversial. There is lack of class 1 evidence regarding tethered cord release surgery in occult spinal dysraphism. Further confusion is caused by lack of classification of the variety of pathologies of OSD. It is recommended that Van leewan classification be used when stratifying data.