Tethered Spinal Cord in Teens and Adults

Tethered spinal cord syndrome is a neurological disorder which limits the movements of the spinal cord within the spinal column as a result of tissue attachments, causing abnormal stretching of the spinal cord. 

This syndrome is closely associated with spina bifida; however, in cases of tethered spinal cord syndrome, the lower tip of the spinal cord is normally located opposite the disc between the first and second lumbar vertebrae in the upper part of the lower back.  Whereas with spina bifida (myelomeningocele), the spinal cord fails to separate from the skin of the back during development, which prevents it from ascending normally resulting in a low-lying, or tethered, spinal cord.

• Lower back pain
• Shooting pain in the legs
• Weakness or numbness in the legs
• Tremors or spasms in the leg muscles
• Problems with movement
• Loss of bowel and bladder control
• Repeated bladder infections
• Changes in the way the feet look (i.e., higher arches or curled toes)
• Cysts that form on the spinal cord
• Scoliosis

The following disorders may also cause tethered spinal cord syndrome:

• Dermal sinus tract (a rare congenital deformity)
• Diastematomyelia (split spinal cord)
• Lipoma (a benign fatty growth)
• Tumor
• Thickened/tight filum terminale (a delicate filament near the tailbone)
• A history of spine trauma
• A history of spine surgery

To diagnose tethered spinal cord syndrome, the doctor performs a physical exam, to look for signs and symptoms. You most likely will have an MRI (magnetic resonance imaging), so the doctor can see inside your body to assess the condition for a confirmation of the diagnosis.

Surgery is a treatment option for tethered spinal cord syndrome; however, to relieve pain if surgery is not advisable, the spinal cord nerve roots may be cut.  In a small percentage of patients, spinal instability may require spinal fusion.

Spinal fusion is an operation that creates a solid union between two or more vertebrae to help relieve severe, chronic spine pain by strengthening and stabilizing the spine.

There are a variety of the different types of lumbar fusions:

• Transforaminal Lumbar Interbody Fusion
• Transpsoas Interbody Fusion
• Anterior Lumbar Interbody Fusion
• Posterior Lumbar Interbody Fusion
• Posterior Lateral Lumbar Fusion

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