Tethered Cord: Is it As Scary As It Sounds?

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Tethered Cord

Tethered Cord Syndrome: a rare neurological disorder that is caused by tissue attachments that limit the movement of the spinal cord within the spinal column. As a result, the individuals range of motion is reduced, blood flow may be disturbed, and neurologic function may worsen. (1)

Clinical Symptoms: Clinical symptoms vary depending on the location of the neural structures that are involved, the age of the patient, the grade of tension on the neural elements, and the level of tethered cord. The most common symptoms are listed below, and surgery is often recommended for patients experiencing the following symptoms. (1)

Skin Stigmata: marks on the skin or ack

Gait: walking abnormalities

Motor disturbances: could result in difficulty walking

Sensory dysfunction: could result in difficulty walking

Decreased sensation: may worsen with movement

Bladder dysfunction: may worsen with movement

Causes of Tethered Cord:

Tethered cord usually results from a congenital malformation. For example, congenital defects that result in incorrect formation of the dura, subarachnoid space, and spinal cord could result in a tethered cord. Additionally, tethered cord may also be caused by a scar that resulted from an infection or trauma. (1)

Treatment:

Typically, spinal roots live freely inside of the spinal cord and are not tethered to any structure. However, when such neural roots become tethered, treatment will vary. If a patient is exhibiting clinical symptoms, surgery is often recommended. Following de-tethering, where the roots are released from the filium, there is a significant improvement in symptoms. However, sometimes there are times where nerve transmission is so damaged, that surgery can not help. (1)

Citations:

Greenfield, Jeffrey P, and Caroline B Long. “Common neurosurgical conditions in the pediatric practice.” Common Neurosurgical Conditions in the Pediatric Practice, 2017, https://doi.org/10.1007/978-1-4939-3807-0. 

Harazeen, Ahmed, et al. “Tethered Cord Syndrome Associated with Lumbar Lipomyelomeningocele: A Case Report.” Cureus, 25 Feb. 2022, www.cureus.com/articles/84408-tethered-cord-syndrome-associated-with-lumbar-lipomyelomeningocele-a-case-report#!/.