Tethered Cord Syndrome

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About Tethered Cord Syndrome

General Information

  • The growth-related syndrome is characterized by a spinal cord located at an abnormally low position within the spinal canal.
  • Tethered cord occurs when the spinal cord cannot normally move upward with growth, causing stretch or damage to the spinal cord.
  • Tethered cord syndrome is associated with a variety of different congenital and acquired conditions, including thickened filum terminale, intradural lipoma, myelomeningocele, diastematomyelia, lipomyelomeningocele, trauma and infection.

Symptoms

  • Skin abnormalities occur in 80 percent to 100 percent of childhood tethered cord and 50 percent of adult tethered cord.
  • Other general symptoms include hypertrichosis (tuft of hair), subcutaneous lipoma (a fatty growth beneath the skin), dermal sinus (opening in the skin), muscle atrophy, short limb and numbness.
  • Symptoms most common in children include difficulty walking, foot deformity, bladder dysfunction and scoliosis (curvature of the spine). In children, symptoms are aggravated by growth spurts.
  • Symptoms common to adults include leg weakness; and pain in the back, legs or foot arches. Adult symptoms are aggravated by trauma, maneuvers associated with stretching of the spine, disc herniation and curvature of the spine.

Diagnosis

  • Magnetic resonance imaging (MRI) can display the low level of the spinal cord and a thickened filum terminale, the thread-like extension of the spinal cord in the lower back.

Treatment

  • Treatment depends upon the underlying cause of the tethering. If the only abnormality is a thickened, shortened filum then limited surgical treatment may suffice.