Tethered Spinal Cord Syndrome

Definition

Tethered spinal cord syndrome is a disorder of the nervous system. It results when tissue attachments of the spinal cord cause the spinal cord to be abnormally stretched.

Causes

Tethered spinal cord syndrome is generally thought to be a result of improper growth of the neural tube during fetal development. It is closely linked to spina bifida. Spinal cord tethering can also develop after a spinal cord injury if scar tissue blocks the flow of fluids. Increasing fluid pressure can cause cysts to form in the spinal cord (syringomyelia).

Symptoms

Many of the symptoms caused by tethered spinal cord syndrome can be delayed as a result of the strain on the spinal cord. Over time, this can cause more problems. In children, symptoms can include:

• Lesions
• Hairy patches
• Dimples or fatty tumors on the lower back
• Foot and spinal deformities
• Leg weakness
• Pain in the lower back
• Scoliosis
• Incontinence

If untreated, tethered cord syndrome can cause additional problems in adults, including:

• Sensory problems
• Motor problems
• Loss of bowel and bladder control

Diagnosis

A number of tools can be used to diagnose tethered spinal cord syndrome:

• Magnetic resonance imaging (MRI)
• Myelogram
• Computed tomography scan (CT or CAT scan)
• Ultrasound

Treatment

A surgical procedure called "untethering" is usually performed only if there are signs or symptoms that the tethered spinal cord is causing deterioration. It involves removing the tissue that is causing the spinal cord to be tethered.