Tethered Cord Syndrome
What is a tethered spinal cord?
A tethered spinal cord is a spinal cord that is pulled down and stuck, or fixed, to the spinal canal. The spinal cord normally floats free inside the spinal canal.
As a child grows, the spinal cord must be able to move freely inside the spinal canal. If the spinal cord is stuck, it will stretch like a rubber band as a child grows. This can cause lasting damage to the spinal nerves.
What causes tethered spinal cord?
Children have tethered spinal cords for many reasons. Tethered spinal cord most often happens in children who have birth defects called myelomeningoceles or lipomyelomeningoceles. Over time, the spinal cords of children with these conditions may become stuck, or tethered, to the myelomeningocele or lipomyelomeningocele. This pulls on the spinal cord as the child grows, causing symptoms.
A child also may have a tethered spinal cord for one of these reasons:
- The very end of their spinal cord is held down more tightly than normal (filum terminale).
- There is a small tract that is not normal, going from the skin into the spinal canal (dermal sinus tract).
- The spinal cord is split into 2 cords near the end (diastematomyelia or diplomyelia).
Symptoms of Tethered Spinal Cord
Children may have several symptoms of tethered spinal cord, including:
- Back pain or shooting pain in the legs
- Weakness, numbness or problems with muscle function in the legs
- Tremors or spasms in the leg muscles
- Changes in the way the feet look, like higher arches or curled toes
- Loss of bladder or bowel control that gets worse
- Scoliosis or abnormal curve of the spine that changes or gets worse
- Repeated bladder infections
- In a child with an unknown tethered cord, signs on the back such as a fatty mass, dimple, birthmark, tuft of hair or anorectal malformations
- Fatty mass, dimple, birthmark, tuft of hair on back
Treatment of Tethered Spinal Cord
Tethered cord needs surgery in form of repair of neural tube defect and detethering of spinal cord under intra operative neuro monitoring.
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