Development of the tethered spinal cord syndrome secondary genesis may be due to the consequences and complications in the fetal and neonatal periods of spina bifida aperta surgical treatment. Currently, a wide range of criteria and indications for surgical Spinal Myelodysplasia (SM) retethering described in the first part of the review, as well as a range of technologies and options for surgical treatment of STSC in spina bifida, allows us to state the need both to prevent the "symptomatic stage" of secondary spinal cord fixation syndrome and motivates the authors and other researchers for further study and evaluation of each and every result and minimal clinical efficacy criteria. The authors present this review as the first sage for the systematic analysis of the neurosurgical treatment and "symptomatic" criteria and SM retethering in SB efficiency.

The search for prospective cohort clinical studies was carried out in the Pubmed, EMBASE, eLibrary and the Library databases, published in the period from 2005 - August 2022, evaluating the methods of the fixed spinal cord syndrome correction in Spina bifida. Two researchers carried out the search for literature data. The study was carried out in accordance with the international guidelines for writing systematic reviews and meta - analyses of PRISMA.

23 articles published between 2009 and 1023 have met the eligibility criteria. 17 publications were pragmatic studies by design and 5 were randomized trials. Mean level of evidence was III. Currently there was no universal and validated score, which would allow to assess neurologic, urodynamic and orthopedic outcomes of detethering surgery. Functional assessment by the use of tractography was seen in 19 out of 23 articles. That indicates the emerging consensus among the experts.

Currently there is a consensus among the experts regarding clinical and neuro visualization criteria of tethered cord syndrome. Despite that, the question of surgical effectiveness directly depends on methods of clinical evaluation used to assess severity of functional deficit (that includes voiding function) and to what degree morpho functional alterations to neural tissue are reversible.
Despite the abundance of clinical scores and questionnaires currently there is no universally implemented system for standardized evaluation of neurologic, urologic and orthopedic deficits in patients with tethered cord syndrome.

There are conflicting opinions and statistically unreliable differences in the frequency of complications after surgical treatment in the literature. Currently, despite the abundance of surgical methods for the treatment of spina bifida, none of them can reliably prevent spinal cord fixation syndrome, which explains the urgency of the problem and the need for further research.