By Dr. Purav Patel, Neurology
The tethered spinal cord is a neurological disorder that occurs when the tissue attachments within the spinal column limit the movement of the spinal cord. Due to these attachments, the spinal cord in the human body becomes stretched abnormally. Tethered spinal cord syndrome is associated closely with a condition known as spina bifida, where the spinal cord does not develop properly.
What are the probable causes of a tethered spinal cord?
The following may be the probable causes of Tethered Spinal Cord Syndrome-
• A history of spinal trauma
• Split spinal cord (Diastematomyelia)
• A rare deformity at birth, like Dermal sinus tract
• A delicate filament at the base of the tailbone
Symptoms associated with Tethered Spinal Cord Syndrome-
Tethered spinal cord syndrome is characterized by the following symptoms-
• Tenderness of the spine
• Deformity of the legs
• The curvature of the spine (Scoliosis)
• Lower back lesion
• Repeated or progressive muscle contraction
• Back pain
• Numbness or tingling sensation of the legs
• Loss of bladder
• Bowel control problems
This neurological disorder often remains undetected in childhood and comes into notice only in adulthood. In such a case, the severity of the symptoms will increase and ultimately lead to motor and sensory problems.
Diagnosis of the disorder-
Tethered spinal cord syndrome can be diagnosed using one or more of the following methods-
• MRI - Uses computer technology and powerful magnets to produce 3D images of the body structure. The image displays the nerve roots and surrounding tissues of the spinal cord along with any displacement, enlargement or degeneration of the same.
• CT Scan - Uses X-ray beams to produce cross-sectional images of the spinal cord and the adjacent nerves
• Myleogram - Injects an X-ray sensitive contrast dye into the thecal sac to show pressure on the nerves or any abnormality of the spinal cord
• Ultrasound - A water-soluble gel is applied to the skin where the transducer is placed so that the sound is transmitted to the surface of your skin. The ultrasound shows images of the spinal cord within the thecal sac.
Tethered spinal cord surgical treatment-
Tethered spinal cord surgery is performed using two methods.
• The neurosurgeon makes a small cut at the back of the spine right below the spinal cord to cut the band of tissue, known as filum terminale. This is a brief procedure and involves very low risks.
• Alternatively, the neurosurgeon cuts open the back and the spinal column to separate the spinal cord from the attached scarred tissue. This allows the spinal cord to move freely. The entire procedure is carried out with the help of microsurgical techniques, but the risk associated with it is relatively high. If tethered spinal cord syndrome is not treated at the right time, it can further lead to damage and permanent deformity of the patient.
Approximately 20-50% of people diagnosed with Tethered spinal cord syndrome after birth will require surgery. Before you opt for the surgery, it is advisable that you speak with your doctor and the neurosurgeon in order to avoid post-surgery complications.