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What is Tethered Spinal Cord Syndrome?
Written by Medicover Team and Medically Reviewed by Dr Vishwa Kumar K S , Neurosurgeons
Tethered Spinal Cord Syndrome is a neurological condition where the spinal cord becomes abnormally attached to surrounding tissues, limiting its movement. This restricted mobility causes stretching and pressure on the cord, potentially damaging nerves. It typically involves the lower spine and can impact both children and adults if not diagnosed and treated early.
What are the Tethered Spinal Cord Syndrome Symptoms and Warning Signs?
Tethered Spinal Cord Syndrome Symptoms may vary based on age, cause, and severity. While some children show signs early, others may not develop symptoms until adulthood.
Common TSCS Symptoms:
- Difficulty walking or frequent falls
- Back or leg discomfort
- Hairy patches, dimples, or skin discoloration on the lower spine
- Bladder or bowel control issues
Severe Symptoms:
Symptoms in Adults:
- Severe Back Pain: Chronic pain that worsens with activity.
- Sensory Changes: Numbness or tingling in the legs or feet.
- Motor Problems: Weakness and difficulty in coordinating movements.
- Sexual Dysfunction: Issues with sexual function due to nerve damage.
- Orthopaedic Deformities: Changes in foot structure or posture.
What Are the Different Types of Tethered Spinal Cord Syndrome?
There are several types of tethered spinal cord conditions, each with unique characteristics and implications:
- Congenital Tethering: This is present at birth and often associated with other spinal abnormalities such as spina bifida or lipomas.
- Acquired Tethering: This develops after birth and can be due to scar tissue from previous surgery, trauma, or infection.
- Occult Tethering: This is a less obvious form where symptoms are present, but the tethering might not be readily visible in imaging tests.
What Are the Common Causes and Risk Factors of Tethered Spinal Cord Syndrome?
Tethered Spinal Cord Syndrome can be attributed to various causes. Understanding these can aid in diagnosis and prevention.
Congenital Causes:
- Neural Tube Defects: Conditions like spina bifida occulta can predispose individuals to tethering.
- Dermal Sinus Tracts: These are rare congenital defects that can tether the spinal cord.
- Lipomas: Fatty tumours that can cause tethering.
Acquired Causes:
- Scar Tissue: Following spinal surgery, scar tissue can form and tether the cord.
- Infections: Infections can lead to inflammation and subsequent tethering.
- Trauma: Injuries to the spine can result in tethering over time.
Risk Factors:
- History of open spina bifida
- Previous spinal cord surgery
- Genetic predisposition (especially for spina bifida)
- Congenital spine or neural tube anomalies
- Physical trauma to the spinal area
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Get Second OpinionDiagnosis of Tethered Spinal Cord Syndrome
The diagnostic process for tethered spinal cord syndrome involves several steps to ensure an accurate diagnosis.
Clinical Evaluation
Symptoms and neurological function are assessed in detail during a clinical examination. And this means conducting assessments of neurological reflexes, muscle strength and sensitivities.
Imaging Tests
- Magnetic Resonance Imaging (MRI): This is the most effective imaging technique for identifying a tethered spinal cord. It provides detailed images of the spinal cord and surrounding structures.
- Ultrasound: Commonly used in infants to visualize spinal movement and anomalies.
- Myelogram with CT Scan: Useful in certain cases to examine spinal fluid flow and cord compression using contrast dye.
At Medicover, our neuroscience unit is equipped with high-resolution MRI, pediatric imaging, and neuro-navigation systems, allowing for precise diagnosis and treatment planning.
What Are the Treatment Options for Tethered Spinal Cord Syndrome?
Treatment options for tethered spinal cord syndrome vary based on the severity of symptoms and the underlying cause.
Surgical Intervention
Surgery is often the primary treatment for tethered spinal cord syndrome, especially when neurological symptoms are present.
- Detethering Surgery: This procedure involves releasing the spinal cord from the tissue attachments. It can prevent further neurological deterioration.
- Laminectomy: Removing a portion of the vertebrae to relieve pressure on the spinal cord.
Non-Surgical Treatments
In cases where symptoms are mild or surgery is not feasible, non-surgical treatments may be considered.
- Physical Therapy: Helps in maintaining mobility and strength.
- Pain Management: Medications and other therapies to manage chronic pain.
When to See a Doctor Tethered Spinal Cord Syndrome?
Early medical attention is crucial to avoid long-term nerve damage. Consult a specialist if:
- A child has skin markings like dimples, moles, or hair tufts near the spine
- There is unexplained back pain or changes in walking pattern
- Urinary or bowel incontinence begins or worsens
- Scoliosis or leg weakness appears without a known cause
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What Precautions Can Help Prevent Tethered Spinal Cord Syndrome?
While congenital cases cannot be prevented, certain measures can reduce the risk of acquired tethering.
Preventive Measures
- Proper Wound Care: After spinal surgery, careful management of the surgical site can minimize scar tissue formation.
- Infection Control: Prompt treatment of spinal infections can prevent complications leading to tethering.
- Regular Monitoring: For individuals with known risk factors, regular check-ups can help in early detection and management.
Complications if Untreated
- Permanent nerve damage
- Progressive muscle weakness
- Chronic back pain
- Impaired bowel and bladder control
- Spinal deformities
How Is Tethered Spinal Cord Syndrome Related to Spina Bifida?
Many children born with spina bifida, especially myelomeningocele, also develop tethered cord syndrome. In such cases, the spinal cord fails to separate normally from surrounding tissues during development. Even after early surgical repair, scar tissue can cause re-tethering as the child grows, necessitating additional monitoring and possible re-surgery.
Key Difference:
- Spina bifida is a structural neural tube defect.
- Tethered cord syndrome is a functional condition often secondary to spinal cord attachment abnormalities.
Our Experience Treating Tethered Spinal Cord Syndrome
At Medicover, we are committed to improving lives through expert neurosurgical care. From early diagnosis to advanced surgical detethering and personalized rehabilitation, our team ensures compassionate, holistic care for children and adults living with tethered spinal cord syndrome. Our multidisciplinary approach helps patients regain control and confidence in their lives.
