A tethered spinal cord is a catch-all term for spinal conditions that restrict the cord’s movement at its base. If your spinal cord can’t move freely in the spinal canal, it can become damaged by its restriction. A tethered spinal cord can develop for a variety of reasons and can be present at birth, but in today’s blog, we’re going to focus on how the condition can affect adults. Below, we take a closer look at some of the causes and treatment options for tethered spinal cords in adults.
Causes Of Tethered Spinal Cords In Adults
There are a number of different underlying causes of the onset of a tethered spinal cord in adults, but it’s worth noting that overall, the condition is quite rare. In some cases, the condition is not spotted at birth and is diagnosed later in adulthood. For others, they develop the condition in adulthood for another reason. In general, we can separate causes of a tethered spinal cord into problems directly or indirect associated with the spinal cord. Some direct causes include:
- Tight filum terminale, where strands of supportive soft tissue at the base of the spinal cord becomes thick and less flexible.
- Split cord malformation, where the cord is split lengthwise in a restrictive fashion.
- Benign growths on the spinal cord
- Myelocystocele, a type of spina bifida where a cyst at the base of the spine can restrict cord movement.
Some indirect causes include:
- Spinal tumors that compress the spinal canal.
- Spinal infections.
- Lipomeningomyelocele, which involves the growth of fatty tissue that becomes entangled with the spinal cord.
- Scar tissue formation after an injury or previous operation.
What’s notable with these causes is that there’s not much you can do to prevent them, so focus shifts to early intervention and symptom awareness. Symptoms of a tethered spinal cord include back pain, pain that radiates to your legs, hips or butt, weakness in the extremities and loss of normal bladder or bowel control. If you’re experiencing any of these conditions, reach out to a spinal specialist right away.
Treating A Tethered Spinal Cord
Since they are so rare, it’s not exactly something your specialist will be looking for right away. Physical tests can help show the doctor you have restrictive spinal movement, but they aren’t going to be able to diagnose the condition without an imaging test. A tethered spinal cord presents well on both an MRI and CT scan, which are the most common ways the condition is confirmed.
Treatment of a tethered spinal cord depends on your symptoms. For patients with mild or minor symptoms, no surgery may be recommended. Observation and range of motion exercises may prove beneficial enough to outweigh the benefits and risks of surgery. If surgery is needed, it will be conducted based on the needs of the individual. That is to say, there’s no one-size-fits-all approach to operating on a tethered spinal cord. While the main goal of surgery will be the same – to relieve tension on the spinal cord – the exact method will vary based on the underlying cause. For some patients, removing a cyst or tumor can provide relief, while others need a more detailed operation on the base of the spinal cord. Your surgeon can walk you through your options should this become necessary for your condition.
The vast majority of patients respond well to surgery, and most stabilize or improve their level of function. Depending on the root cause of the tethering, it’s possible for the condition to return, so follow up care and monitoring will be recommended for most patients.
For more information, or to talk to a specialist about your spine pain, reach out to Dr. Chang’s office today.