The spinal cord is one of the most incredible structures in the human body and is involved in many key functions. It is responsible for transmitting messages to and from the brain and is also involved in important autonomic responses such as maintaining blood pressure, keeping us breathing and bowel and bladder function.
Damage to the spinal cord can have wide-ranging and dramatic consequences. Not all damage, however, is caused by an accident or traumatic injury such as a fall or car crash.
A rare and often misdiagnosed condition that can be either congenital or acquired later on in life is tethered spinal cord syndrome.
Simply put it’s a condition that restricts the movement of the spinal cord at the base because the cord is tethered or tied to the spine by tissue or an abnormality.
As the body begins to develop in younger patients, this is likely to cause major issues with the spinal cord being stretched rather than growing naturally. This, in turn, can cause nerve damage and pain as time goes on which then needs to be rectified by surgery.
While a tethered spinal cord can be acquired in later life, it most commonly occurs in infants. It is often associated with spina bifida. This is a condition where the fetal spinal cord fails to close properly during development and a child is born with part of their spine exposed at the back.
The Spina Bifida Association estimates that between 20% and half of children will require medical intervention to deal with a tethered spine. With these conditions, the spinal cord does not separate from the skin of the back and needs to be operated upon.
A tethered spinal cord can also occur in children because of a fatty mass or lipomyelomeningocele that again restricts growth and requires removal.
The good news is that, once an accurate diagnosis has been made, tethered spinal cord surgery can make a big difference and has an excellent prognosis.
While the association with spina bifida and a congenital fatty deposit on the spine are the most common causes of a tethered spinal cord, there are others.
A tethered spinal cord is not always diagnosed immediately after birth and there are several symptoms that may indicate there is a problem in this area. These include:
If a person is suspected of having a tethered spinal cord, there are a number of tests that can confirm the diagnosis. These include an MRI scan, CAT scan, ultrasound and a myelogram. Testing often involves injecting a contrast material into the thecal sack so that any tethering will show up.
If tethered spinal cord syndrome is identified, the next step depends on the age of the patient and the cause of the tethering. In children, because the spine is still growing, surgery is preferred to ‘untether’ the cord. In adults, more conservative approaches may be taken depending on the severity of the problem and the symptoms.
The prognosis for children undergoing tethered spinal cord surgery is very good and many are able to return to normal activity within just a couple of weeks.
A tethered spinal cord is a rare health problem that is most often associated with other conditions such as spina bifida. Tissue attachments prevent the spinal cord from being able to grow properly. Though even rarer, it can also occur in adults for a variety of reasons, most notably because of previous trauma or spinal surgery.
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