In tethered cord syndrome, the spinal cord is abnormally attached to surrounding tissues, causing a variety of neurological symptoms. Symptoms, causes, diagnosis, treatment, and prevention of tethered cord syndrome are explained in this article.
There are several factors that can cause tethered cord syndrome, including:
Tethered cord syndrome can be caused by congenital anomalies, such as spina bifida or myelomeningocele.
Trauma to the spine or spinal cord can result in scarring or adhesions, tethering the spinal cord.
The spinal cord can be tethered and stretched by benign or malignant tumors in the surrounding tissues.
The spinal cord can become tethered following previous spinal surgery, particularly when tumors are removed or deformities are corrected.
After surgery, infection, or inflammation, scar tissue can tether the spinal cord and impair its function.
The symptoms of tethered cord syndrome vary depending on the severity of the tethering and the age of onset, but may include:
A persistent or recurrent pain in the lower back, buttocks, or legs, typically after prolonged sitting or standing.
Having difficulty moving the legs, feet, or toes, particularly when walking, climbing stairs, or lifting objects.
Numbness, tingling, or loss of sensation in the legs, feet, or genital region.
Incontinence, urinary or fecal incontinence, or recurrent urinary tract infections are symptoms of bladder or bowel dysfunction.
Walking abnormalities include dragging the feet, walking on tiptoes, or tripping frequently.
In individuals with tethered cord syndrome, particularly those with congenital anomalies, scoliosis, kyphosis, or other spinal deformities may occur.
If left untreated, progressive weakness, paralysis, or loss of motor function in the lower extremities can result.
The diagnosis of tethered cord syndrome usually involves a combination of clinical evaluation, medical history, and diagnostic tests. Diagnostic procedures might include:
During a physical examination, a healthcare provider will assess neurological function, muscle strength, reflexes, and sensation in the lower extremities, as well as examine any spinal abnormalities.
MRI or CT scans are used to visualize the spinal cord and surrounding structures, assess for signs of tethering, compression, or abnormalities, and rule out other conditions.
Studies of electrophysiology: Nerve function can be assessed with electromyography (EMG) or nerve conduction studies.
Individuals with symptoms of bladder dysfunction may undergo urodynamic testing, such as uroflowmetry or cystometry, to assess bladder capacity, detrusor function, and urinary sphincter control.
Tethered cord syndrome treatment aims to relieve symptoms, prevent neurological deficits from progressing, and preserve or improve quality of life. Treatment options include:
Surgically untethering the spinal cord, also known as tethered cord release or detethering, may be recommended to release adhesions, remove tumors, or correct spinal deformities.
Tethered cord syndrome may be treated with medications such as pain relievers, muscle relaxants, or antispasmodics to relieve pain, muscle spasms, or bladder and bowel dysfunction.
Individuals with tethered cord syndrome can benefit from rehabilitation exercises, stretching, and strengthening programs supervised by a physical therapist.
Individuals with severe neurological deficits may benefit from assistive devices such as braces, orthotics, or mobility aids.
Regular follow-up appointments with healthcare providers, such as neurologists, orthopedic surgeons, and urologists, are essential to monitoring symptoms, assessing treatment response, and detecting disease progression.
Individuals can take steps to reduce their risk and minimize complications of tethered cord syndrome, including:
Regular prenatal care and screening during pregnancy can help identify and manage tethered cord syndrome-associated congenital anomalies or fetal abnormalities.
Preventing spinal injuries: Wearing protective gear during sports or activities that may pose a fall or accident risk can help reduce the risk of tethered cord syndrome.
Symptoms of spinal cord injury, infection, or inflammation should be evaluated and treated promptly to prevent the progression of tethered cord syndrome.
