Information on Tethered Spinal Cord Syndrome

Information on Tethered Spinal Cord Syndrome
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Anatomy of the Spine

Most people do not know that the spinal cord is actually a nerve. In fact, it is the largest nerve in the human body. The spinal cord consists of nerve fibers that carry messages to and from the brain, allowing for basic functions such as movement and breathing. Since this large nerve controls so many important functions, the vertebral column encases the spinal cord and protects it from injury. The vertebral column consists of small bone segments called vertebrae.

Tethered Cord

The spinal cord normally moves freely within the spinal column. In tethered cord syndrome, tissue attachments form within the spinal column. As the spinal cord moves, the tissue attachments catch the spinal cord, causing it to stretch abnormally.

Causes

The National Institute of Neurological Disorders and Stroke, a division of the National Institutes of Health, reports that this condition often occurs in cases of neural tube defects. It is closely associated with spina bifida, which occurs when the spinal canal does not close properly during fetal development. Tethered cord syndrome can also occur following traumatic injury to the spinal column. Other causes of this syndrome include the following:

  • Tumors
  • Spinal surgery
  • Split spinal cord
  • Benign fatty growths
  • Tight filum terminale
  • Dermal sinus tract

Signs & Symptoms

Symptoms of tethered cord syndrome include skin discoloration of the lower back, hair patches on the lower back, back pain that gets worse with activity, pain in the back of the legs, numbness and tingling of the legs, lesions on the lower back, leg deformities, bowel and bladder problems and a curved spine. Tethered cord is rare in adults, but it can continue into adulthood if not diagnosed in childhood. In adulthood, tethered cord leads to worse motor problems and loss of bladder and bowel control.

Diagnosis

Doctors use several diagnostic tests to confirm the presence of a tethered spinal cord. MRI (magnetic resonance imaging) produces images that show displacement or degeneration of the spinal cord. Computed tomography (CT scan) also creates images that help identify spinal cord damage. Doctors use the myelogram to identify pressure on the spinal cord. This test involves the injection of a contrast material into the spinal canal.

Treatment

Doctors do not perform surgery for tethered cord unless it causes significant loss of movement or bladder and bowel problems. During this surgery, a surgeon exposes the spinal cord and gently dissects it away from the tissue attachments that have formed. Neurosurgery Today reports that this procedure has a one to two percent complication rate, but children can usually resume their normal activities within a few weeks of the operation. If the spinal cord tethers again, a repeat surgery may be required.

References

National Institute of Neurological Disorders and Stroke: Tethered Spinal Cord Syndrome Information Page

Neurosurgery Today: Tethered Spinal Cord Syndrome