The spinal cord is located in the dural tube, which is actually a fluid-filled sac inside the spinal column. This spinal fluid protects the spinal cord and keeps it from rubbing against or touching the dural tube. When the spinal cord becomes attached to a structure such as one of the vertebrae in the spinal column, this is known as tethered spinal cord. As a person with tethered spinal cord grows taller, the spinal cord becomes stretched and causes several bothersome symptoms (University of Washington at http://faculty.washington.edu/chudler/spinal.html).
Tethered Spinal Cord and Spina Bifida
According to the Spina Bifida Association of America (www.sbaa.org), people with Spina Bifida are particularly prone to developed tethered spinal cord. Spina Bifida is a neural tube defect that is caused by the spinal column’s failure to close completely during development. When the spinal column does not close completely, an opening exists in the vertebral column. The spinal cord may become attached to the vertebral column through this opening, leading to tethered spinal cord.
Tethered Spinal Cord Symptoms
Tethered spinal cord can lead to several symptoms that worsen depending on the severity of the tethering. According to Neurosurgery Today (http://www.neurosurgerytoday.org/what/patient_e/tethered.asp), dimples or hairy patches on the skin of the back can signal a tethered spinal cord even if other symptoms have not been identified. Because the spinal cord controls so many functions, other symptoms of tethering include loss of bowel or bladder control, difficulty walking, leg muscle weakness, back pain, and deformities of the feet.
Tethered Spinal Cord Diagnosis
If the symptoms above are noted, physicians will recommend further testing to determine if tethered spinal cord is the cause. Boston Neurological Foundation (http://www.boston-neurosurg.org/publications/faq/tethered_cord_MP.shtml), lists X-rays as the first step in this additional testing, with magnetic resonance imaging (MRI) often needed to produce clearer images of any problem. If a tethered spinal cord is detected, additional scans of the brain and spinal cord can be performed to assess the severity of the problem. Electromyography (EMG) can also be used to determine how much nerve damage has resulted from the tethered spinal cord.
Tethered Spinal Cord Treatment
Treatment for tethered spinal cord usually involves surgery to release the tethered cord from where it has become attached to an immovable structure. When a patient has recovered from the surgery, function usually improves and symptoms such as muscle weakness and back pain may be resolved. Once this surgery has been performed, patients must get regular follow up care from their physicians because tethered spinal cord often occurs more than once (Boston Neurological Foundation).
Tethered Spinal Cord Prognosis
According to the National Institute for Neurologic Disorders and Stroke (www.ninds.org), the outlook for people who experience tethered spinal cord is usually good. If tethering occurs at birth or in childhood, the dimpled skin or hairy patches of skin can alert physicians to the problem so it can be corrected early. The symptoms of pain, weakness, and loss of function usually do not occur until tethering has become severe, which gives physicians time to develop a successful treatment plan.
Reference:
- Neurosurgery Today www.neurosurgerytoday.org/what/patient_e/tethered.asp
