What is Tethered Cord Syndrome?

Tethered Cord Syndrome (TCS) is a neurological condition where the spinal cord is abnormally attached to the spinal column. Normally, the spinal cord moves freely inside the spine, but in TCS, this attachment restricts its movement. As a child grows, the spinal cord stretches. In TCS, this stretching can pull on the spinal cord and damage nerves, leading to pain, weakness, or problems with bladder and bowel control.

TCS can be:

• Congenital – present at birth.

• Acquired – develops later, after injury, infection, or surgery.
  
  

Causes

Tethered Cord Syndrome may occur due to:

• Birth defects such as spina bifida.

• Thick or tight filum terminale (attachment between the spinal cord and tailbone).

• Fatty or tumor-like growths on the spinal cord.

• Previous spinal surgery or infection causing scar tissue.

• Injury to the spine.
  
  

Symptoms

Symptoms often appear in childhood but may also occur later. These include:

• Loss of bladder or bowel control (incontinence).

• Frequent urinary tract infections.

• Weakness or numbness in the legs.

• Trouble walking or abnormal gait.

• Pain in the lower back, worse with movement.

• Foot, leg, or spinal deformities, such as:

  • Curved spine (scoliosis).

  • A small dimple, patch of hair, or discolored area on the lower back.
    
    

Diagnosis

Your child’s doctor may recommend imaging and nerve tests such as:

• MRI – the most common and accurate test.

• CT scan or ultrasound (in infants).

• Myelogram – special X-ray with dye to view spinal cord details.

• EMG and nerve conduction studies – check for nerve or muscle damage.

Treatment

• Surgery is the only effective treatment if symptoms are present.

• The goal is to release (untether) the spinal cord to prevent further nerve damage.

• Early surgery offers the best outcome and can prevent permanent neurological problems.
  
  

Home Care

• Give all medicines exactly as prescribed.

• Attend all follow-up appointments for monitoring and recovery checks.

• Watch for new or worsening symptoms and report them promptly.

When to Contact a Doctor

Call your child’s doctor if your child:

• Develops new or worsening back pain.

• Feels tingling, numbness, or weakness in the legs.

• Starts having accidents (loss of bladder or bowel control).

Seek emergency care immediately if:

• Your child has severe pain.

• Loses sensation or movement in any part of the body.
  
  

Summary
Tethered Cord Syndrome occurs when the spinal cord is abnormally attached to the spine, causing nerve damage as a child grows. Early diagnosis and surgery can prevent long-term complications and help your child lead a normal, active life.