Tethered Cord Syndrome (TCS), often known more simply as Tethered Cord, is a condition resulting from an abnormal attachment between the spinal cord and the tissue around the base of the spine. The result is that the spinal cord is held taut and is unable to move freely within the spinal canal. If left untreated, it can cause progressive damage to the spinal cord and a range of neurological problems.
TCS is often diagnosed during childhood, although it can sometimes go undetected until adulthood, depending on the severity of the patient's individual symptoms. The condition is causally linked to Chiari 1 Malformation and so, on occasion, Chiari 1 Malformation patients may also have a tethered spinal cord.
Tethered Cord is usually present at birth and is most commonly the result of the neural tube growing improperly whilst a baby is still in the womb. It is closely associated with another common birth defect, Spina Bifida.
In addition, the onset of the condition may result from an injury to the spinal cord, especially in cases when the scar tissue interferes with the natural flow of spinal fluids.
Symptoms of TCS can vary from patient to patient. Children suffering from Tethered Spinal Cord Syndrome may experience problems including:
Adults with the condition may also experience similar symptoms in later life. The severity of symptoms will depend on the amount of strain placed upon the spinal cord. Bladder control issues often get progressively worse and, as a result, are more common amongst adults with TCS.
After receiving a report of the above symptoms, specialists will attempt to confirm a diagnosis of Tethered Cord Syndrome. This is usually achieved through MRI and CT scans, among other imaging techniques.
Following diagnosis, a consultation with the patient will be set up, in order to discuss the various treatment methods available to them.
For children suffering from Tethered Spinal Cord Syndrome, early surgery is recommended in order to de-tether the spinal cord and prevent as much neurological deterioration as possible. This is because most neurological problems caused by TCS cannot be reversed.
Amongst adult patients, surgery is usually also the primary method of treatment, as this can relieve many symptoms and, in some circumstances, may restore function. This is especially important in patients who report a sudden worsening of pain and bladder control. However, patients who have reached adult age, while experiencing minimal symptoms, may be advised to postpone surgery for as long as possible.
Patients suffering from incontinence as a result of the condition may be referred to urology and/or gastroenterology specialists, while mobility issues may be treated further by a physiotherapist.
Following treatment, the vast majority of TCS patients are able to live normal, fulfilling lives, with minimal disruption. In many cases, surgery will help to relieve symptoms and will prevent any further deterioration.
However, because it will usually be impossible to reverse serious neurological deterioration, the focus is on preventing such deterioration from taking place.