INFORMATION ON TETHERED SPINAL CORD SYNDROME

Tethered spinal cord syndrome is a neurological disorder caused by tissue attachments that limit the movement of the spinal cord within the spinal column. These attachments cause an abnormal stretching of the spinal cord. The course of the disorder is progressive. Tethered spinal cord syndrome may go undiagnosed until adulthood, when sensory and motor problems and loss of bowel and bladder control emerge. A tethered cord refers to a condition in which the lower spinal cord is restricted and cannot grow normally with the spinal column. As the spinal column grows, the restricted cord stretches beyond its tolerance which can then result in lower spinal cord dysfunction. The result is a spinal cord that is stretched beyond its tolerance and results in damage to nerve cells, nerve fibers, and blood vessels.

SYNONYMS OF TETHERED SPINAL CORD SYNDROME

1. Occult Spinal Dysraphism Sequence
2. Congenital Tethered Cervical Spinal Cord Syndromes
3. Occult Spinal Dysraphism Sequence
4. Tethered Cervical Spinal Cord Syndromes
5. Tethered Cord Malformation Sequence
6. Tethered Cord Syndromes

CAUSES OF TETHERED SPINAL CORD SYNDROME

1. Caused by tissue attachments that limit the movement of the spinal cord within the spinal column.
2. Tethered spinal cord syndrome appears to be the result of improper growth of the neural tube during fetal development, and is closely linked to spina bifida.
3. Abnormal stretching of the spinal cord.

SYMPTOMS OF TETHERED SPINAL CORD SYNDROME

The symptoms and signs are of cord syndrome include loss of function in the legs and/or loss of bowel or bladder control. Other symptoms and signs include:-

1. Decrease in strength of legs or feet
2. Deformity of the legs or hips
3. Loss of reflexes and sensation in the legs
4. Stumbling or walking changes
5. Leg or back pain
6. Curvature of the spine
7. Skin abnormalities directly overlying the spinal cord – midline dimples, sinuses or tracts leading from the skin toward the spinal cord, birthmarks, hairy patches, skin discoloration, skin tags or fatty lumps

DIAGNOSIS OF TETHERED SPINAL CORD SYNDROME

Tethered spinal cord syndrome may go undiagnosed until adulthood, when sensory and motor problems and incontinence occurs. Others may include:-

1. Magnetic resonance imaging : A diagnostic test that produces three-dimensional images of body structures using powerful magnets and computer technology; can show the spinal cord, nerve roots, and surrounding areas, as well as enlargement, degeneration, and displacement.
2. Myleogram: An x-ray of the spinal canal following injection of a contrast material into the thecal sac; can show pressure on the spinal cord or nerves due to tethered spinal cord.
3. Computed tomography scan: A diagnostic image created after a computer reads x-rays; may be used after a myelogram to show how the dye flows around the spinal cord and nerves.
4. Ultrasound: A water-soluble gel is placed on the skin where the transducer is to be placed. The gel helps transmit the sound to your skin surface. The ultrasound is turned on and images of the spinal cord moving in the thecal sac are obtained.

TREATMENT OF TETHERED SPINAL CORD SYNDROME

Following can be done during the treatment process:

1. In the case of tight filum terminale, the filum terminale is severed, allowing the cord to float freely.
2. In children, early surgery is recommended to prevent further neurological deterioration. If surgery is not advisable, spinal cord nerve roots may be cut to relieve pain.
3 In adults, surgery to free the spinal cord can reduce the size and further development of cysts in the cord and may restore some function or alleviate other symptoms. Other treatment is symptomatic and supportive.
4 europhysiologists are present to monitor spinal cord and nerve functioning to reduce the risk of damage to nerves and other tissues.