What is a Tethered Spinal Cord?
A tethered spinal cord is a condition where there is restricted movement of the spinal cord, which lies within the spine, surrounded by the vertebrae.
Vertebrae are the bones in your neck and back. They are the bony building blocks for your spinal column and protect your spinal cord, a thick bundle of nerve cells that carries messages for movement and feeling to all parts of the body.
A tethered spinal cord can be caused during fetal development, or it can be from scar tissue in children who have had spine surgery. If untreated, tethering of the spinal cord can cause permanent damage. The type of damage depends on where in the spine the tethering occurs.
If your child has the symptoms described and has been diagnosed with spina bifida, diastematomyelia, dermal sinus, syringomyelia or imperforate anus, they have an increased risk for a tethered spinal cord.
Symptoms of a Tethered Spinal Cord
Symptoms usually appear gradually as a child grows because as the spine grows, the tethering becomes worse. The normally mobile and free spinal cord is held in one place, causing pulling on, and decreased blood supply to, the spinal cord.
Common signs and symptoms include:
- Trouble with, or changes in, bowel and bladder function
- Loss of strength in the legs or feet
- Pain in the legs or back
- An abnormal walking pattern, such as walking on the toes
- A difference in the size of the right and left legs or feet
- New or increased spasticity
- Unusual birthmarks or dimples on the back, which may indicate an underlying tethered spinal cord
Ideally the tethered cord is treated soon after diagnosis because long-standing symptoms may not improve after the spinal cord is untethered. The goal of treatment is to prevent the symptoms from worsening and, in some cases, to reverse them.
Treatment for a Tethered Spinal Cord
A tethered spinal cord is treated surgically. Your child's neurosurgeon will remove a small amount of bone from the spine to reach the spinal cord. They will then free the tissue that is preventing the spinal cord from moving within the spine.
There are risks with every surgery. With this surgery, the risks include excessive bleeding, infection, injury to the spinal cord, persistent leaking of spinal fluid, and anesthesia complications.
There are also risks of not having surgery for a tethered spinal cord, including further progression of the symptoms with permanent damage to the spinal cord. This could include a total loss of bladder and bowel control, progressive scoliosis and the loss of the use of the legs.
When to Call Your Child's Doctor
If your child has any of the symptoms of a tethered spinal cord, it is important to have them examined by your primary care provider, who will refer you to a neurosurgeon if needed.