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Tethered Spinal Cord

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How is Tethered Spinal Cord Syndrome Diagnosed?

Diagnosis

If you believe you or your child may have symptoms of tethered spinal cord syndrome, a neurologist will need to learn more about your symptoms and medical history to confirm a diagnosis and rule out other conditions.

Tethered spinal cord syndrome diagnosis will involve a physical exam, assessing your symptoms, and a review of your medical history. Your doctor may also order the following tests:

  • MRI. An MRI provides detailed views of your spinal cord. This is the most common and reliable test to diagnose tethered spinal cord syndrome.
  • CT scan. A CT scan uses X-rays to examine the inside of your body. In the case of tethered spinal cord syndrome, your neurologist may conduct a CT scan in tandem with a myelogram — another imaging test that involves the injection of a contrast dye into the membrane surrounding your spinal cord. Any abnormalities, including tethered spinal cord, will then appear on the X-ray.
  • Ultrasound. Ultrasound is another imaging test that employs high-frequency sound waves to examine your spinal cord, including how it moves within your spinal canal. Neurologists will typically use an ultrasound to assess infants.

How is Tethered Spinal Cord Syndrome Treated?

Treatments

Tethered spinal cord syndrome cannot be resolved independently and can be progressive if not treated, so surgery is the main treatment option.

There are a variety of surgical procedures and approaches to treat a tethered spinal cord, depending on the patient's age and the thickness of your filum terminale, the fibrous tissue that forms the end of your spinal cord.

Surgical options

A neurosurgeon will typically conduct tethered cord surgery to “untether” the spinal cord from the spinal canal. There are several different approaches to untethering during surgery, which will vary depending on the cause.

  • Laminectomy. A laminectomy is a procedure in which the neurosurgeon removes part of the bones, or vertebrae, in the spine to access the spinal cord. Once the spinal cord can be reached, the neurosurgeon then pulls it away from the buildup of scar tissue that is tethering it to the spinal canal. Laminectomies also sometimes involve placing a patch onto the spinal cord to prevent cerebrospinal fluid from leaking.
  • Surgery for thick or fatty filum terminale. If your tethered spinal cord is caused by a thick filum terminale, your neurosurgeon will conduct a laminectomy, which completely removes the lamina (the roof, or back part, of the spinal canal) or a laminotomy, which removes just a portion of the lamina, to untether the spinal cord.
  • Surgery for tumors. Sometimes tethered spinal cord syndrome is caused by the growth of tumors or tissue tethering the spine to the nerves around it. In this case, your neurosurgeon will remove the mass or tumor to untether the spine.

Nonsurgical options

Following tethered cord surgery, your care team may provide you with follow-up care to monitor your recovery, relieve any symptoms, and prevent further nerve or spinal cord damage through nonsurgical options.

In addition to frequent follow-up appointments to monitor your recovery, your team may provide you with medications or have you undergo physical therapy to improve muscle function and reduce pain.

FAQs

FAQs

While tethered spinal cord syndrome is not a disability in and of itself, its progression and complications can lead to disability, such as inability to walk, difficulties with motor skills, and inability to control bladder or bowel movements. In severe cases, tethered spinal cord syndrome can result in lower body paralysis.

Generally, people will take about four to six weeks to recover from tethered spinal cord surgery. During the recovery period, you should avoid physical activity or lifting heavy objects.

Tethered spinal cord surgery typically takes about two hours, and you may spend two to three days in the hospital following surgery .

 

This content has been reviewed by the following medical editors.

Ibrahim Hussain, MD

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Trust NewYork-Presbyterian for Tethered Spinal Cord Treatment

If you believe you or your child may be exhibiting symptoms of tethered spinal cord syndrome, the specialists at NewYork-Presbyterian are here to help. Internationally renowned for treating tethered spinal cord syndrome and other spinal cord disorders, our team of experts will build a personalized treatment plan for you. It’s important to be aware of the symptoms of the condition, so you can seek treatment as early as possible to prevent further progression or damage. Call us today to set up an appointment and get connected to your care team.