Tethered Spinal Cord

A tethered spinal cord occurs when the lower part of the spinal cord attaches to the meninges (the membrane around the cord).This keeps the cord from being able to move freely. As a child grows and moves around, the spinal cord gets stretched and pulled, and this can cause problems with pain and movement.

Tethered spinal cord is often seen in patients who have spina bifida. Children with spina bifida often have some tethering but may not need treatment unless they have symptoms. Other causes can include injury or infection to the spine, spinal surgery, or a tumor on the spine.

Symptoms

Symptoms vary from child to child, and depend on how severe the tethered cord is. Symptoms may include:

  • A lesion, dimple or patch of hair on the lower back
  • Changes in the growth of the spine or feet
  • Foot deformities, such as club foot or hammer toes
  • Pain or weakness in the legs or back
  • A numb or tingling feeling in the legs
  • Trouble walking that worsens over time or with activity that improves with rest
  • Scoliosis
  • Changes in bladder and bowel control 

Symptoms can appear in infants, children or later in life during adulthood. When symptoms appear depends on how severe they are and how they progress.

A tethered spinal cord is diagnosed by medical testing, which may include a/an:

  • X-ray
  • Ultrasound 
  • CT scan
  • MRI 
  • Muscle tests to check for movement, feeling and strength
  • Tests to check the kidneys and bladder

Symptoms may worsen over time. Damage to the spinal cord can occur if surgery is not done when advised by your child’s doctor. Your child’s doctor will talk with you about the risks, benefits and complications of surgery for your child.

Treatment

Early surgery can sometimes help prevent new symptoms and damage. If your child’s legs and back were weak before surgery, physical therapy can sometimes improve muscle strength or movement. Some children may need more surgeries as they grow. Routine follow-up is important to check healing and to make sure re-tethering does not occur.

When to contact the doctor

After your child has surgery, call your child’s doctor right away if your child has:

  • Signs of infection at the surgery site, such as drainage or a bad smell, increased redness, warmth or tenderness
  • A temperature above 100.3°F or 38°C
  • Any problems or symptoms that return or get worse after surgery, such as:
    • Weakness or numb or tingling feelings in the legs or feet
    • Change in bladder or bowel control
    • Trouble walking or moving
    • Pain not relieved by pain medicine

Call your child’s doctor if you have any concerns about how your child looks or feels.