Tethered Spinal Cord
What is a tethered spinal cord?
Tethered spinal cord syndrome, or tethered cord, is a condition in which your spinal cord becomes attached to your lumbar spine.
Normally, your spine floats in a cushion of cerebrospinal fluid within the center of your spinal column. This allows it to move freely with bending and stretching and also protects it from stress as the bones of your spinal column grow.
There are many conditions that can cause a tethered cord, including:
- Chiari malformations, where the brain extends into the top of the spinal canal
- Spina bifida, or structural defects of the lower spinal cord
- Trauma or injury to your lower back
- Scar tissue from surgery
- Tumors or cysts in and around your spinal cord
Symptoms of Tethered Spinal Cord
The symptoms of tethered cord can vary widely. In addition, symptoms in children are often different than those that appear in adults.
Symptoms in children can include:
- Lesions, fatty tumors, hair growth, dimple, or skin discoloration on the lower back
- Pain in the legs or lower back
- Difficulty walking
- Bedwetting or urinary accidents
- Deformities in the legs and feet
Symptoms are detectable by the age of 4 years old in 70 percent of children. Your child’s symptoms will almost always worsen as children grow, and some neurological deficits may not be reversible.
In adults, these symptoms are similar but may be more severe due to growth putting more tension on the spinal cord over time.
Treatments for Tethered Spinal Cord
If your tethered cord is causing only mild symptoms or no symptoms at all, your doctor may recommend observation over surgery. However, surgery may be indicated with even mild symptoms, as often neurological function that has been lost will not return after surgery to repair your tethered cord.
For severe cases, the only chance for relief is through surgery. This involves opening the lower back to expose the abnormality that is pinning the cord in place and fixing or removing it.
How common is tethered cord and what are the risk factors?
Tethered cord can happen in both children and adults. Approximately two of every 1,000 people are born with a tethered cord, but as mentioned above, sometimes tethered cord develops as a result of noncongenital factors like scar tissue or the growth of tumors or cysts in your spinal cord.
How is tethered cord diagnosed?
If tethered cord is suspected, magnetic resonance imaging (MRI) will be used to view your lower spinal cord and verify that it is attached to the surrounding structures.