Your spinal cord is made of a collection of nerves that run from your brain to your lumbar spine. It is protected by a spinal column and cerebrospinal fluid, which allows it to move as needed as the body performs physical tasks. In rare instances, the spinal cord can be tethered or attached to part of the spinal column, restricting its free movement. This restriction can be asymptomatic, or it can result in severe symptoms. Below, we explain how the condition is treated when it develops in adults.
Causes, Symptoms And Diagnosis Of A Tethered Spinal Cord In Adults
A tethered spinal cord is more common in infants and toddlers, and the condition is typically addressed with a surgical procedure, which is easier before the column and nerves become fully grown. However, the condition can also develop in adults. Oftentimes it is the result of an undiagnosed tethering in childhood that eventually led to symptoms as an adult, or it is due to restriction caused by scar tissue following a previous spine surgery. In many instances, patients may have a minor tethering and not know about it because it does not cause symptoms.
For patients who are experiencing symptoms, they can range from mild to severe. The most common symptoms include headaches, back pain, leg pain, muscle weakness and urinary problems like routinely needing to go to the bathroom and not being able to fully empty the bladder. If symptoms are making life difficult, you’ll want to connect with a spine specialist to determine a diagnosis.
Because it’s very rare, a tethered spinal cord is not typically the first condition that is looked for if patients are presenting with some of the above symptoms. If symptoms and physical tests suggest that a tethered spinal cord may be to blame, a spine specialist will likely order an MRI. The MRI will allow the doctor to visualize the spinal cord and rule out any other possible conditions like a pinched nerve or a herniated disc. Your doctor may also refer you to a urologist for an appointment if bladder issues are present to ensure the best treatment plan can be developed.
Treating A Tethered Cord In Adults
While surgery is the typical course of action for children with a tethered cord, that’s not the case for adults. Tethered cord surgery on an adult tends to be more complex, and adults tend to be less tolerant of surgeries than younger bodies, which can make this a more difficult procedure. Because of this, mose adults diagnosed with tethered cord syndrome will first see if medications can help to decrease symptoms and make life more bearable. Surgery tends to be reserved for patients with moderate to severe bladder and leg dysfunction.
When surgery is recommended in adults, it is typically performed in one of two styles:
- Detethering – During a detethering operation, the surgeon will work to separate the spinal cord from the tissue of the spinal canal causing the restriction. This is complex, but tends to yield great results when performed successfully.
- Spinal Shortening – During a spinal shortening procedure, part or all of a vertebral disc in the spinal column is removed. This shortens the spinal column, which in turn limits the restriction on the spinal cord. It is not a common operation, but it may be pursued if attacking the scar tissue or tethering is too risky.
To learn more about the condition, or to talk to a spine specialist about your back pain, reach out to Dr. Sinicropi’s office today.