Tethered cord treatment as an adult? Outcome?

Hello everyone,
I am hoping to connect with others who may have experience with adult tethered cord, dural ectasia, or nerve root adhesion.

My recent MRI showed pronounced dural ectasia, and the end of my spinal cord (the conus) is tethered to the back of the thecal sac at L1–L2. Several cauda equina nerve roots also appear adherent. This has progressed compared with my prior MRI, and I have bilateral leg and foot numbness, pulling sensations, and occasional balance issues. I also have ankylosing spondylitis with some spinal fusion, which may be contributing.

I met with a neurosurgeon at a major Boston hospital who felt that surgery was not the right option for me at this time. However, a neurology associate at Brigham and Women’s reviewed my imaging and strongly recommended that I speak with a few neurosurgeons who specialize in these types of intradural and CSF related spine conditions. I am trying to gather as much information as I can before moving forward.

I would really appreciate hearing from anyone who has:
• A similar combination of tethered cord and dural ectasia in adulthood
• Chosen to undergo detethering surgery and what the outcome was
• Decided not to have surgery and how things have progressed over time
• Had symptoms stabilize with conservative management
• Been evaluated at a center specializing in CSF or complex spinal cord disorders

I am trying to understand what others have experienced so I can make the best decisions moving forward. Thank you so much for any insight or guidance you are willing to share.