If not found and treated early, tethered cord syndrome can cause permanent damage.
In embryonic development, the bones of the spine, or vertebrae, develop faster than the spinal cord, which is the major column of nerve tissue contained within the spine. Initially, the spinal cord reaches one of the lower vertebrae and, over time, continues to grow. In normal development, the cord moves freely within the spine. However, in some fetuses, the spinal cord becomes attached to the spine, a condition known as tethered cord syndrome. This condition is often found in children with abnormalities such as spina bifida, but can also be caused by tumor or scar tissue. Throughout childhood, symptoms can become more pronounced.
Recognizing the Symptoms
The condition is often denoted by discoloration or a patch of hair on the skin overlying the spine or a dimple or tumor at the lower back. The child experiences back pain and can also exhibit neurological abnormalities such as lack of sensation in the leg or hip. He may have trouble walking. Symptoms can increase gradually and may also include weakness, abnormal curvature of the spine (scoliosis) or bowel and bladder dysfunction. If the condition is not found and treated, pressure on the spine increases and neurological abnormalities can become permanent.
Diagnosing the Syndrome
If tethered cord is suspected in an infant, ultrasound is performed, which often finds the source of the problem. If the condition is not recognized until after infancy, it is often identified by a physical abnormality near the lower spine, at which time magnetic resonance imaging (MRI) is performed, as well as X-ray and CT scan to identify the cause and location. If a problem is identified through these tests, the health care provider will recommend electromyography to evaluate the soundness of the nerves in the area.
Treating the Problem
Surgery is the recommended treatment for tethered cord. The earlier the syndrome is identified and surgery performed, the less neurological damage will occur. An open approach to this type of spine surgery repairs the abnormality and monitors neurological function so that additional damage to the nerves does not occur. Monitoring continues after surgery to ensure that the spinal cord does not become tethered again. When open surgery cannot be performed, surgeons often treat the problem by cutting adjacent nerve roots to ease pain. In some cases, individuals with a tethered cord do not experience severe symptoms until adulthood, and when this is the case, surgery is not necessary until pain and dysfunction occur. In addition to surgery, neurologists also recommend symptomatic relief with rehabilitation and/or medication.
Tags: spinal cord, tethered cord, abnormalities such, condition often, cord syndrome, found treated, neurological abnormalities