Tethered cord syndrome

[1] Various forms include tight filum terminale, lipomeningomyelocele, split cord malformations (diastematomyelia), occult, dermal sinus tracts, and dermoids.

[1] The spinal cord normally hangs loose in the canal, free to move up and down with growth, and with bending and stretching.

[2][3] In children, symptoms may include: Tethered spinal cord syndrome may go undiagnosed until adulthood, when sensory, motor, bowel, and bladder control issues emerge.

This can lead to additional loss of movement or feeling, or the onset of pain or autonomic nervous system symptoms.

These symptoms include urinary frequency and urgency, feeling of incomplete voiding, poor voluntary control, nocturia, and urge and stress incontinence.

Female patients also give a history of ineffective labor and postpartum rectal prolapse, presumably due to an atonic pelvic floor.

With milder forms of Spina bifida such as Occulta, may be related to the degree of strain on the cord which can become worse with physical activity, injury, pregnancy, bone spurs, or spinal stenosis.

The tethered cord in this case might not be diagnosed until adulthood when it worsens and can still cause neurological, orthopedic, and urological dysfunctions.

[12] Tethered spinal cord syndrome is a clinical entity which is manifested by progressive motor and sensory changes in: In order to understand the pathophysiology that is involved in a tethered spinal cord, the reduction/oxidation ratio has to be used in vivo of cytochrome alpha and alpha 3 to signal the oxidative metabolic functioning in humans.

Studies have found that marked metabolic and electrophysiological susceptibility to hypoxic stress to the lumbar and sacral portion of the spinal cord under traction with various weights.

[14] Similar effects were found in redox behavior of tethered spinal cord during the surgical procedures to repair it.

[22][23] In children, early surgery is recommended[24] to prevent further neurological deterioration, including but not limited to chronic urinary incontinence.

[25][26] A vertebral osteotomy aims to indirectly relieve the excess tension on the spinal cord by removing a portion of the spine, shortening it.

However, its complexity and limited “track record” presently keeps vertebral osteotomies reserved as an option for patients who have failed in preventing retethering after detethering procedure(s).

For example, a website from the Columbia University Department of Neurosurgery says, "For the child that has reached adult height with minimal if any symptoms, some neurosurgeons would advocate careful observation only.

Studies have shown surgery can help improve low back pain, urinary symptoms leg weakness and walking distance.