Tethered Cord Syndrome


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What Is a Tethered Cord?

A tethered cord refers to a condition in which the lower spinal cord is restricted and cannot grow normally with the spinal column. As the spinal column grows, the restricted cord stretches beyond it’s tolerance which can then result in lower spinal cord dysfunction. The result is a spinal cord that is stretched beyond its tolerance and results in damage to nerve cells, nerve fibers, and blood vessels. Disorders which can lead to tethered cord syndrome include:

Myelomycloceles
Lipomylomyncelos
Dermal sinus tracts
Split cord malformations

How Is Tethered Cord Diagnosed?

The symptoms and signs of a tethered cord are not always obvious and many patients may experience a delayed diagnosis. It is important to diagnose this condition as soon as possible because the neurological defect that results from abnormal stretching of the spinal cord may not be reversed by surgery.

The most common signs of tethered cord syndrome include loss of function in the legs and/or loss of bowel or bladder control. Other symptoms and signs include:

Decrease in strength of legs or feet
Deformity of the legs or hips
Loss of reflexes and sensation in the legs
Stumbling or walking changes
Leg or back pain
Curvature of the spine
Skin abnormalities directly overlying the spinal cord – midline dimples, sinuses or tracts leading from the skin toward the spinal cord, birthmarks, hairy patches, skin discoloration, skin tags or fatty lumps.

What Is the Treatment for a Tethered Cord at LPCH?

Patients suspected of having tethered cord may go through the following steps for evaluation and treatment:

Spinal x-rays
MRI
Somatosensory evoked potentials – to evaluate nerves and electrical impulse transmissions through the spinal cord
Bladder function evaluation by a pediatric urologist
Surgery

It is important that a neurosurgical assessment is made as early as possible after the onset of symptoms. The care of patients with tethered cord is very complex and is therefore best handled by pediatric neurosurgeons trained in treating tethered cord syndrome. If surgery is recommended to release the tension in the spinal cord, this is often a fairly simple and effective procedure. The main purpose of the surgery is to stop any further deterioration of neurological function.

If you would like more information on tethered cord syndrome or to schedule an appointment with a specialist, please call the Pediatric Neurology Clinic at (650) 724-4270 or the Pediatric Neurosurgery professional office at (650) 497-8775.

Lucile Packard Children's Hospital is located in Palo Alto, adjacent to Stanford University Hospital, approximately 20 miles north of San Jose, CA and 40 miles south of San Francisco.

Lucile Packard Children's Hospital
725 Welch Road
Palo Alto, California 94304
(650) 497-8000