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by EBSCO Medical Review Board
(Tethered Spinal Cord Syndrome; TCS)

Definition

Tethered cord syndrome (TCS) is an abnormal attachment of the spine to the tissue around it. This makes it hard for the spine to move freely. It also leads to strain and stretching on the spinal cord. This can damage nerves and cause pain. Early treatment can improve outcomes.

Causes

TCS may be present at birth. This form is caused by a problem with the way the spine forms during pregnancy. A baby may also have other birth defects, such as spina bifida.

TCS that develops after birth may be caused by:

  • Scar tissue following surgery
  • Infection
  • Trauma to the spinal cord
  • A tumor

Risk Factors

TCS is usually diagnosed in childhood, but it may not be found until problems occur in when a person is an adult.

The risk of this problem may be higher in adults with:

Spinal Stenosis
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Symptoms

TCS symptoms vary with age, but most often appear in young children. Some may never have symptoms. Rarely, a person may not have symptoms until they are an adult.

Problems may be:

  • Moles, hair growth, a dimple, or a lump over the lower back
  • Back pain
  • Pain in the legs or groin
  • Numbness and weakness in the legs
  • Changes in the way the legs and feet look
  • Difficulty walking or running
  • Problems controlling urine or stool

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. It will focus on the back.

Images of the spine will be taken. This can be done with an MRI scan .

Treatment

The goal of treatment is surgery to release the tethered cord. The type of surgery done will depend on what is causing TCS.

People who do not have surgery will be monitored for any changes. Symptoms can be managed with:

  • Medicines, such as:
    • Pain relievers
    • Muscle relaxants
  • Physical therapy to promote strength, flexibility, and range of motion in the spine

Prevention

Folic acid supplements and proper prenatal care lower the risk of this problem during pregnancy.

RESOURCES

American Association of Neurological Surgeons  http://www.aans.org 

Healthy Children—American Academy of Pediatrics  https://www.healthychildren.org 

CANADIAN RESOURCES

Canadian Neurological Sciences Federation  http://www.cnsfederation.org 

Caring for Kids—Canadian Paediatric Society  http://www.caringforkids.cps.ca 

References

Hertzler DA 2nd, DePowell JJ, et al. Tethered cord syndrome: a review of the literature from embryology to adult presentation. Neurosurg Focus. 2010 Jul;29(1):E1.

Tethered cord syndrome. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/tethered-cord-syndrome. Accessed February 19, 2021.

Tethered spinal cord syndrome. American Association of Neurological Surgeons website. Available at: http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Tethered%20Spinal%20Cord%20Syndrome.aspx. Accessed February 19, 2021.

Treatments for tethered spinal cord in children. Boston Children’s Hospital website. Available at: http://www.childrenshospital.org/conditions-and-treatments/conditions/t/tethered-spinal-cord/treatments. Accessed February 19, 2021.

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