排尿需要膀胱、周围神经网络、脊髓和大脑之间的复杂相互作用。脊髓裂畸可出现多种神经病变，可能影响这种相互作用，导致神经原性膀胱。然而，在脊髓裂畸患者中诊断神经原性膀胱通常很困难，并与由完全神经损伤引起的其他类型神经原性膀胱（如脊髓损伤或脑肿瘤）进行对比。通常，由脊髓裂畸引起的神经原性膀胱表现为下运动神经元损伤和部分神经损伤。然而，在部分患者中，可能出现上运动神经丧失迹象，并伴有发生脊髓牵拉综合征和膀胱控制发育不成熟，并常常并发大便祛结。因此，脊髓牵拉综合征的诊断应谨慎进行。多种侵入性和非侵入性诊断方法可用于准确诊断，防止肾脏损害和控制尿失禁。然而，值得注意的是，单个研究不能确定准确诊断，因此需要仔细解读。应确定这些患者的随访方案，以检测因脊髓牵拉综合征的发展而引起的泌尿系统恶化。由于脊髓牵拉综合征的发展涉及泌尿系统和骨科问题等多种因素，多学科合作对综合护理至关重要。© 2023. 作者(们)独家授权给Springer Nature Switzerland AG。

Micturition requires complex interplay involving bladder, peripheral neural network, spinal cord, and brain. Spinal dysraphism presents variety of neural lesions that may affect this interplay leading to neurogenic bladder. However, the diagnosis of neurogenic bladder in those with spinal dysraphism is often difficult and contrasted to other types of neurogenic bladder caused by complete neural lesions such as spinal cord injury or brain tumor. Typically, neurogenic bladder caused by spinal dysraphism shows lower motor neuron lesion and partial neural injury. However, upper motor signs can be seen with the occurrence of tethered cord syndrome and developmental immaturity of bladder control often complicated by fecal impaction. Thus, the diagnosis of tethered cord syndrome should be made cautiously. Several invasive and noninvasive diagnostic modalities could be applied for accurate diagnosis, preventing renal damage and controlling urinary incontinence. However, it should be borne in mind that no single study is definitive for accurate diagnosis, so it requires careful scrutiny in interpretation. The follow-up scheme of these patients should be determined to detect urological deterioration due to the development of tethered cord syndrome. Since the development of tethered cord syndrome shows diverse nature implicating urological and orthopedic issues, multidisciplinary collaboration is essential for comprehensive care.© 2023. The Author(s), under exclusive license to Springer Nature Switzerland AG.