What is Tethered Cord Syndrome?
Tethered cord syndrome is a condition characterized by a restricted spinal cord within the spinal canal that cannot move upward with growth, causing stretching or damage to the spinal cord. This syndrome is closely associated with spina bifida, however it can occur in children who do not have spina bifida as well.
What are the Causes of Tethered Cord Syndrome?
Tethered cord syndrome usually occurs when the spinal cord does not separate from the skin of the back while a baby is developing before birth. Also, when a baby is born with spina bifida, some of the spinal cord sits at the bottom of their back instead of stretching up the spine the way it should.
What are the Symptoms of Tethered Cord Syndrome?
Skin abnormalities occur in most childhood cases and 50 percent of adult tethered cord cases. Some of the other general symptoms include:
- Hypertrichosis or abnormal hair growth
- Subcutaneous lipoma or a fatty growth beneath the skin
- Dermal sinus tract
- Muscle atrophy
- Short limb and numbness
In children, symptoms are aggravated by growth spurts and may include:
- Difficulty walking
- Foot and spinal deformities
- Bladder dysfunction
- Scoliosis or curvature of the spine
Symptoms in adults are aggravated by disc herniation, a curvature of the spine, trauma, and maneuvers associated with stretching of the spine. Common symptoms include:
- Leg weakness
- Pain in the back, legs or arches of the feet
How is Tethered Cord Syndrome Diagnosed?
If you have any of the above symptoms, it is necessary to consult your doctor. A thorough history and neurological physical examination are performed in which a neurosurgeon will assess how the nerves and reflexes are working. Other tests include:
- An MMT which measures lower body strength
- MRI of the spine and sometimes the head
- Spine x-rays
- Urodynamic test which shows how well the bladder empties and fills
What are the Treatment Options for Tethered Cord Syndrome?
Treatment depends upon the underlying cause of the tethering. Surgery is the main treatment for a tethered cord. Immediate intervention helps improve recovery chances and can prevent further functional decline.
In children, treatment involves early surgery to prevent further neurological deterioration. Regular follow-up is important. In cases where surgery is not recommended, spinal cord nerve roots may be cut to relieve pain.
In adults, treatment involves surgery to free the spinal cord which can reduce the size and further development of cysts in the cord. Surgery may also restore some function or alleviate other symptoms.
Treatment helps you to have a normal life expectancy. However, some motor impairments and neurological problems may not be fully correctable.