Tethered Spinal Cord

What is a tethered spinal cord?

Tethered spinal cord syndrome is a progressive neurological disorder resulting from abnormal attachment of the neural tube during fetal development. When the spinal cord attaches to tissue around the base of the spine, it can’t move freely within the spinal canal. This causes the spinal cord to stretch like a rubber band as the spine grows, which can result in pain and nerve damage. While the condition is typically progressive, it’s treatable when diagnosed and addressed early.

Causes of a tethered spinal cord

A tethered spinal cord can develop either in utero or after birth. It is closely associated with spina bifida.

Spina bifida is a birth defect that occurs when the neural tube doesn’t close all the way in the first month of pregnancy, resulting in damage to the surrounding spinal cord and nerves. Doctors aren’t sure why this occurs but have determined that taking folic acid during early pregnancy reduces instances significantly. Spina bifida is typically diagnosed by a blood test or ultrasound during pregnancy. It is usually apparent at birth by an abnormal tuft of hair or a small dimple at the site of the spinal malformation. The higher the malformation is on the back, the greater the amount of damage. Many people with spina bifida have normal intelligence and lead active lives. Some patients may benefit from surgeries, medications, physical therapies, and assistive devices.

It’s estimated that 20 to 50% of spina bifida patients will require surgery to untether their spinal cord. It may also be caused by dermal sinus tract, diastematomyelia, lipoma, or a tumor. Spinal trauma or surgery can also result in a tethered spinal cord.

Signs of a tethered spinal cord

Some symptoms of tethered spinal cord include hairy patches, dimples, lesions, or fatty tumors on your child’s lower back. The skin may be discolored in that area. A child may have back pain, leg pain, or leg numbness. Other symptoms may include tremors, scoliosis, and spine tenderness. A child may also experience loss of bladder control and frequent bladder infections.

While it is rare, some patients may go undiagnosed until adulthood. The strain on the spinal cord would increase motor and sensory problems, as well as other symptoms.

Diagnosis

If a tethered cord is suspected, your doctor will perform an MRI to get images of the spinal cord, nerve roots, and surrounding areas. A myelogram, which is an X-ray of the spinal cord with an injected dye, will help show pressure on the spinal cord or nerves. A CT scan or ultrasound may also be used.

Treatment

Surgical untethering is generally performed when symptoms are present. Children need regular follow-up care, as retethering can happen during periods of rapid growth. When surgery is not advisable, spinal cord nerve roots may be cut to relieve pain. In some cases, a spinal fusion may be performed to create a solid union between two or more vertebrae. This procedure may assist in strengthening and stabilizing the spine and may help to relieve severe and chronic neck pain. Surgery can help relieve symptoms and future complication, but it cannot correct neurological damage that has already occurred, meaning that early treatment is recommended.

What You Can Expect at UTHealth Neurosciences

Our dedicated team uses advanced technology to accurately diagnose and treat neurological diseases and conditions impacting babies and children. We work in multidisciplinary teams of specialists and pediatric neurosurgeons who share insights, leading to better treatment decision-making and outcomes, as well as lower costs and time savings. Throughout treatment, we will work closely with the doctor who referred your family to ensure a smooth transition back to your child’s regular care. While your family is with us, they will receive expert care, excellent communication, and genuine compassion.

Contact Us

At UTHealth Neurosciences, we offer patients access to specialized neurological care at clinics across the greater Houston area. To ask us a question, schedule an appointment, or learn more about us, please call (713) 486-8000, or click below to send us a message. In the event of an emergency, call 911 or go to the nearest Emergency Room.