What is Tethered Spinal Cord Syndrome?
What is Tethered Spinal Cord Syndrome?Tethered spinal cord syndrome, also known as tethered cord syndrome or tethered spinal cord, is a rare neurological disorder in which tissues surrounding the spine in the spinal canal attach to the spinal cord, restricting its movement.
A tethered spinal cord can limit blood flow and damage your spinal cord, which carries nerve signals from your brain to your body, resulting in pain, numbness, incontinence, or other neurological issues. Tethered spinal cord syndrome is rare, and has an incidence of about 0.25 per 1,000 births.
Tethered spinal cord syndrome is often associated with scoliosis and spina bifida. Spina bifida is a defect of the neural tube, a tube-shaped structure that forms a baby’s spinal cord and brain in the early stages of development. Spina bifida is present at birth and occurs when the neural tube does not close all the way. Children born with spina bifida often have a tethered spinal cord at birth. Scoliosis, meanwhile, is the abnormal curvature of the spine. In some cases, scoliosis is a manifestation of a tethered spinal cord.
In rare situations, tethered cord can occur due to prior surgeries involving the spinal cord that result in scar tissue formation.
Signs & Symptoms of Tethered Spinal Cord Syndrome
TypesThe symptoms of tethered cord syndrome can vary greatly from patient to patient, depending on when the person begins to experience symptoms. Generally, neurological symptoms may include numbness in the legs or back, severe back pain, and difficulty walking.
Some patients will experience tethered cord symptoms at birth, while others may begin to experience symptoms as they grow up. In rare situations, people may not develop symptoms until they reach adulthood.
Tethered cord syndrome symptoms include:
- Difficulty walking
- Patches of hair on lower back
- Dimples on lower back
- Noncancerous tumors on lower back
- Severe leg or back pain that can extend to the rectum or genitals
- Numbness in the legs and back
- Skin tags
- Difficulties with bladder and bowel control
- Cysts in the spinal cord
- Spine tenderness
- Scoliosis
If you believe you may have signs of tethered spinal cord, the specialists at NewYork-Presbyterian can help assess your symptoms for a proper diagnosis and create a personalized treatment plan.
What Causes Tethered Spinal Cord Syndrome?
CausesTethered spinal cord syndrome can be caused by a variety of underlying issues, depending on whether it’s present at birth (congenital) or appears later in life (acquired).
Spina bifida is a common cause of congenital tethered cord syndrome, as the spinal cord is unable to separate from the back during development. Scoliosis may also cause tethered cord.
Other causes include:
- Benign fatty growth (lipoma) in the spinal cord
- Dermal sinus, a rare birth defect
- Splitting of the spinal cord (diastematomyelia)
- Tumors in and around the spinal cord
- Thickening of the fibrous tissue in the spinal cord
- Repeated spine surgeries
- A history of spinal trauma or injuries
Risk Factors
Risk FactorsMany risk factors of tethered cord syndrome are congenital, including having tight filum terminale (a fibrous band of tissue at the end of the spinal cord), lipomeningomyelocele (a growth of fatty tissue on the spinal cord), or split cord malformation (a rare congenital disorder in which the spinal cord is split, or duplicated). There are also cases in which adults develop the disease later on due to certain risk factors. Those include:
- Genetic factors
- Past spinal trauma or injuries, which can form scar tissue that binds to the spinal cord
- Past spinal surgeries
- Development of tumors
- Infection
Complications
ComplicationsIf left untreated, tethered spinal cord syndrome can lead to a variety of complications resulting from ongoing damage to the spinal cord. Complications may include:
- Permanent nerve damage
- Loss of movement and walking function
- Inability to control bladder or bowels
- Lower body paralysis (rare)
Prevention
PreventionIn most cases, tethered cord syndrome cannot be prevented. In some cases, however, it’s acquired as a result of trauma or injury, so it’s important to be careful when playing sports, lifting heavy objects, and partaking in any extreme physical activity.
Early treatment can also help to reduce or reverse symptoms. Typically, a neurosurgeon will perform spinal cord surgery that removes scar tissue and creates space between your spinal cord and spinal canal. The earlier the treatment, the better the chances of reversing symptoms.
After surgery, you may need physical therapy to help alleviate some lasting symptoms as well as prevent any other nerve damage.
Trust NewYork-Presbyterian for Tethered Spinal Cord Syndrome Care
Tethered spinal cord syndrome can have serious complications, making everyday life difficult if left untreated. Our expert teams at NewYork-Presbyterian include neurologists, neurosurgeons, and physical therapists with experience treating patients living with tethered spinal cords.
Your team will also include internationally renowned leaders in research, ensuring you receive the most cutting-edge therapies available. Call us to schedule an appointment with our specialists who will create a personalized treatment plan for you.