What’s Tethered Cord Syndrome?

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Tethered cord syndrome (TCS) can be a birth defect that occurs with or without spina bifida or a side effect of any spinal surgery. Tethered cord syndrome occurs when the spinal cord becomes attached to the spine, most often in the lower back, and can cause both physical and developmental symptoms. TCS is most often treated with surgery to detach the cord from the spine.

The spinal cord is thought to hang freely within the spine. TCS makes the cable unable to do this; the condition forces the spinal cord to stretch as the body grows or moves, thereby affecting nerves and neurological development and function. Spina bifida, which occurs in the first trimester of pregnancy when the neural tubes don’t close, can cause the cord to become attached to the spine, limiting its growth. In some cases, TCS may be present at birth without spina bifida, although this is rare. Tethered cord syndrome can also occur after surgery for spina bifida or other spinal surgery. The cord can essentially capture scar tissue left over from surgery, thus causing TCS.

Symptoms of TCS can include skin discoloration or lesions and the presence of fat deposits on the back. It can, in some cases, also cause excess hair to grow on the back. Tethered cord syndrome can cause developmental delays in children, foot deformities, and back pain. In adults, it can cause problems walking and loss of bladder and bowel control. Symptoms vary based on where on the spine the cord is attached.

Tethered cord syndrome is typically diagnosed with an X-ray and MRI. A relatively short surgery, usually five hours, is then performed to detach the cord from the spine. In cases of congenital tethered cord syndrome, if surgery is done early enough, the symptoms can be eliminated or drastically reduced. In adults, if done promptly, surgery can also reverse most of the damage. However, both infants and adults who experience tethered cord syndrome are likely to always have problems with bladder and bowel control, although the severity may lessen after surgery. In many cases, neurological problems due to TCS are not reversible, although early surgery can greatly limit the extent of neurological damage.

Both children and adults who have tethered cord syndrome may require several follow-ups to determine if the cord has reattached to the spine, which is a relatively common problem. Just as the cord can become entangled in scar tissue from previous surgeries, it can become entangled in scar tissue left over from surgery to treat TCS. Therefore, subsequent interventions are common.

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