Tethered cord syndrome (TCS) is a group of neurological symptoms caused by an abnormal attachment of the spine. The spinal cord is a bundle of nerves that normally sit freely in the bony spinal column. This allows the spine to move freely without straining the soft tissue of the spinal cord.
In TCS, the abnormal attachment of the spinal cord to tissue around the spine causes strain on the spinal cord during normal movements. The strain and stretching on the spinal cord can damage the nerves and cause a variety of symptoms.
TCS is usually diagnosed in childhood, but it may not be found until problems occur in adulthood. Earlier treatment of TCS can help reduce the chance of permanent damage.
Congenital TCS is present at birth. It is caused by abnormal development of the spine during pregnancy. It is often associated with other birth defects, such as spina bifida.
Acquired TCS develops after birth. Some causes include:
Growths that press into the spinal cord and restrict movement such as:
You will be asked about your symptoms and medical history. A physical exam will be done. If structural problems of the spine are suspected imaging tests will be done. TCS is diagnosed with an
—The goal of surgery is to release the tethered spinal cord, ease symptoms, and prevent further damage. The exact type and extent of surgery will depend on what is causing the TCS and how much the nearby tissue is affected. Surgical steps may include:
Removal or release of the tether
Debulking of problematic tissue
Repair or release of nearby structures
More than one surgery may be needed. The spinal cord may also reattach and require a repeat surgery.
—TCS can cause nerve damage that cannot be reversed. Some symptoms can persist after surgery. Rehabilitation can help develop a plan to manage any remaining challenges. It may include:
Physical therapy to regain as much movement as possible and keep muscles strong
Occupational therapy to assist in everyday tasks and self-care
Psychological therapy for coping, support, and to decrease the risk of depression
Folic acid supplements and proper prenatal care may reduce the risk of spinal defects during pregnancy.
Tethered spinal cord causes and treatments. Spinal Stenosis website. Available at: http://spinalstenosis.org/blog/tethered-spinal-cord-treatments. Published September 16, 2013. Accessed November 27, 2017.
Tethered spinal cord syndrome. American Association of Neurological Surgeons website. Available at: http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Tethered%20Spinal%20Cord%20Syndrome.aspx. Accessed November 27, 2017.
Treatments for tethered spinal cord in children. Boston Children’s Hospital website. Available at: http://www.childrenshospital.org/conditions-and-treatments/conditions/t/tethered-spinal-cord/treatments. Accessed November 27, 2017.
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