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What is tethered cord syndrome?
Tethered cord syndrome is a disorder caused by tissue attachments that limit the movement of the spinal cord within the spinal column. These attachments cause abnormal stretching of the spinal cord.
A normal spinal cord extends from the base of the brain to the lower back. It hangs freely within the bony vertebrae and soft tissues of the spinal column. At its base, the spinal cord is attached to the spinal column with a strand of elastic tissue. The elastic tissue allows the cord to stretch and move without injury. Beyond the lower end of the spinal cord are nerves that lead to the muscles of the legs, lower bowel and bladder.
In children with tethered cord syndrome, the spinal cord and column don't develop normally. The spinal cord attaches (becomes tethered) to the lower portion of the spinal column. Since the spinal cord grows more slowly than the spinal column, the cord becomes stretched and stressed over time, causing neurological damage. Bending and stretching movements of the body put additional tension on the tethered spinal cord.
What are the signs of tethered cord syndrome?
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Weakness in the legs or feet
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Deformity of the legs, hips or feet
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Loss of reflexes
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Leg numbness or tingling
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Bladder and bowel control problems
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Low back pain
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Leg pain, especially in the back of legs
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Curvature of the spine
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Awkward way of walking or frequent stumbling
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Lesions, skin discoloration, hairy patches, dimples or fatty tumors on the lower back
What is the cause of tethered cord syndrome?
Tethered cord syndrome is most often found in children with spina bifida. Less common causes include:
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Dermal sinus tract (a rare deformity)
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Diastematomyelia (split spinal cord)
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Thickened/tight filum terminale (a delicate fiber near the tailbone)
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Pediatric spine injury
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Spine surgery
How is tethered cord syndrome diagnosed?
If you suspect that your child has tethered cord syndrome, it's important to get a neurosurgical assessment. If left untreated, tethered cord syndrome can cause permanent damage to the nerves and muscles that control movement of the legs, feet, bowel and bladder.
The multi-disciplinary spine team at Le Bonheur Children's Medical Center may use the following diagnostic tests to determine if your child has tethered cord syndrome:
How is tethered cord syndrome treated?
For most children, early surgery is recommended to prevent further nerve and muscle damage. The objective of surgery is to detach the cord where it is attached.
Many children require only one untethering procedure. However, since symptoms of tethering can occur during periods of growth, some children require follow-up procedures.
If surgery is not advisable, spinal cord nerve roots may be cut to relieve pain.
Why Le Bonheur Children's?
The spine team at Le Bonheur Children's Medical Center are some of the most well respected pediatric surgeons in the United States. The hospital's spine program is dedicated to the treatment and research of pediatric spinal conditions. Children from across the country visit Le Bonheur each year for treatment.
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