Tethered (Spinal) Cord Syndrome

What is tethered (spinal) cord syndrome?

Tethered (spinal) cord syndrome is a stretch-induced functional disorder that is characterized by the fixation or tethering effect of tissue on the caudal spinal cord and caused by tissue attachments that limit movement of the cord within the spinal column. This effect causes increased tension of the spinal cord as a child ages and limits movement overall.

What causes tethered (spinal) cord syndrome?

Tethered cord syndrome is either from a primary origin or an acquired (secondary) origin. Specifically, primary origins of the disease include congenital anomalies such as spina bifida and birth defects at the end of the spinal cord, as well as genetic factors and inelastic filum terminale in between the tip of the spinal cord and the tailbone. Secondary origins of the disease include tumors, infections, or scar tissue in the spinal cord. In addition, some activities which flex or extend the lower spinal column can worsen the condition.

What are the symptoms of tethered (spinal) cord syndrome?

The specific symptoms and severity of tethered cord syndrome vary from one individual to another. In pediatric cases, the associated symptoms include:

Cutaneous tufts of hair and skin tags
Lower back pain
Leg pain or numbness
Difficulty walking
Foot and spinal deformities
Difficulties with bladder and bowel control
Scoliosis

In addition, although adult onset of tethered cord syndrome was considered to be rare for many years, there has been an increasing number of cases in recent years. These cases have similar signs and symptoms as pediatric cases.

How is tethered (spinal) cord syndrome diagnosed?

Tethered cord syndrome is diagnosed after an identification of the characteristic signs and symptoms of the condition. Detailed MRI scanning must be carried out to help with this process, as well as a thorough clinical evaluation and patient history. Furthermore, demonstration of spina bifida will support a diagnosis of tethered cord syndrome.

What are the available treatments for tethered (spinal) cord syndrome?

Since tethered cord syndrome is functional and physiological in nature, it can be reversible (i.e.”untethered”) if it is surgically treated in an early stage. If surgery is not possible, spinal cord nerve roots can be cut to help relieve pain. Other treatments for tethered cord syndrome are symptomatic and supportive, on an as-needed basis.