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.