目的　探讨小儿脊髓栓系综合征 (TCS)的病理及手术治疗效果。方法　本组TCS患儿 2 1例 ,检查确诊后 ,手术切除脂肪瘤或切除瘢痕、松解粘连、切断终丝 ,使TCS得以松解。结果　TCS在大体病理上有脂肪瘤型及瘢痕型两大类 ,部分病例有神经根缺失。 19例得到随诊 ,单纯双下肢软瘫的 1例治愈 ,17例尿失禁患儿中 ,3例治愈 ,6例明显好转 ,8例无变化。结论　TCS患儿应尽早治疗 ,疗效确切。对脊髓脊膜膨出患儿应在TCS松解的同时作修补术 ,因单纯修补术的副损伤往往是严重的。 Objective To investigate the pathology and surgical treatment of pediatric tethered cord syndrome (TCS). Methods Twenty-one children with TCS in this group were diagnosed as having undergone surgical resection of lipoma or scar removal, lyse adhesions, cut off the terminal filaments and release the TCS. Results TCS in gross pathology has two major types of lipoma and scar, some cases of nerve root loss. 19 cases were followed up, 1 case of simple double lower limbs paralysis was cured, 17 cases of urinary incontinence in children, 3 cases were cured, 6 cases improved significantly, 8 cases no change. Conclusion TCS children should be treated as soon as possible, the exact effect. Children with spinal meningocele should be repaired at the same time TCS release repair, as simple repair of the secondary injury is often serious.