A neurological disorder which is caused by tissue attachments which tend to limit the movement of the spinal cord within the spinal column is known as the Tethered Spinal Cord Syndrome. These attachments may be present at the base of the spinal cord or may develop around an injury to the spinal cord causing an abnormal stretch in the spinal cord. The symptoms of this progressive disease may include lesions, hairly patches, tumors on the lower back, foot and spinal deformities, weakness in the legs, low back pain and incontinence.
It may be develop due to the improper growth of the neural tube during fetal development and is closely linked to spina bifida. But there are cases when it may go undiagnosed until adulthood due to delayed presentation of symptoms. This delay in the appearance of symptoms is related to the degree of strain placed on the spinal cord over time which may become more evident during sports and pregnancy.
The tethering may also develop due an injury to the spinal and scar tissue can block the flow of the fluids around the spinal cord. Pressure of fluid may cause cysts to form syringomyelia in the spinal cord which can lead to further loss of movement, feeling or the onset of pain or automatic symptoms.
Following tests must be conducted on suspicion of getting a tethered cord to confirm the diagnosis
It is used to produce three-dimensional images of body structures with the use of powerful magnets and computer technology. This diagnostic test shows the spinal cord, nerve roots, and surrounding areas, as well as enlargement, degeneration, and displacement.
An x-ray of the spinal canal with a following injection of a contrast material into the thecal sac is used to show pressure on the spinal cord or nerves due to tethered spinal cord.
A diagnostic image is created after a computer reads x-rays. This can be used after a myelogram to show how the dye flows around the spinal cord and nerves.
A water-soluble gel is placed on the skin where the transducer is to be placed. The gel helps in transmitting the sound to the skin surface. The ultrasound is turned on and images of the spinal cord moving in the thecal sac are obtained.
MRI imaging is often used to diagnose the location of the tethering and to evaluate individuals with these symptoms. In children, early surgery is recommended to prevent further neurological deterioration. Besides, regular follow-ups are also important as retethering may occur in some individuals during periods of rapid growth and may be seen between five to nine years of age. In cases where surgery is not advisable, spinal cord nerve roots may be cut to relieve the pain. While in adults, surgery is done to free the spinal cord can reduce the size and further development of cysts in the cord and may restore some function or alleviate other symptoms. Other treatments are symptomatic and supportive.
Image Courtesy : Getty Images
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