Tethering of the spinal cord is a condition in which the spinal cord becomes attached to the spinal column via surrounding structures. Normally, the spinal cord hangs loose in the canal, freely moving up and down with growth, bending and stretching. A tethered cord does not move. It is pulled tightly at the end, reducing blood flow to spinal nerves and causing damage to the spinal cord from both the stretching and the decreased blood supply.
Tethering can happen before or after birth in children and adults; and most often occurs in the lower (lumbar) level of the spine. All forms of SB can be accompanied by spinal cord tethering; but it rarely occurs with Spina Bifida Occulta (SBO). In children, a tethered cord causes the spinal cord to stretch as the child grows. In adults, the spinal cord will stretch during the course of normal activity which like bending and stretching. If a symptomatic tethered cord (tethered cord syndrome) is left untreated, it can lead to progressive, permanent spinal cord damage.
Tethered cord syndrome is the presence of several clinically recognizable signs (observed by a physician), or symptoms (reported by the patient) that occur together as a result of the tethering. These signs and symptoms can include: sensory disturbance, significant muscle weakness (as determined by neuro assessment), pain, and incontinence.
Many techniques have been tried to prevent or minimize tethering, but only surgical untethering has been successful in long term studies. Research continues into this important area. With close observation, it should be possible to diagnose this condition early and untether the cord before progressive and permanent damage occurs.
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