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Tethered Spinal Cord in Teens and Adults

Tethered spinal cord syndrome is a neurological disorder caused by tissue attachments that limit the movement of the spinal cord within the spinal column. These attachments cause an abnormal stretching of the spinal cord.

This syndrome is closely associated with spina bifida. The lower tip of the spinal cord is normally located opposite the disc between the first and second lumbar vertebrae in the upper part of the lower back. In people with spina bifida (myelomeningocele), the spinal cord fails to separate from the skin of the back during development, preventing it from ascending normally, so the spinal cord is low-lying or tethered.

The following disorders may also cause tethered spinal cord syndrome:

  • Dermal sinus tract (a rare congenital deformity)
  • Diastematomyelia (split spinal cord)
  • Lipoma (a benign fatty growth)
  • Tumor
  • Thickened/tight filum terminale (a delicate filament near the tailbone)
  • A history of spine trauma
  • A history of spine surgery

Symptoms

  • Low back pain
  • Cysts that form on the spinal cord
  • Problems with movement
  • Loss of bowel and bladder control

Treatment

Surgery is a treatment option for Tethered Spinal Cord. If surgery is not advisable, spinal cord nerve roots may be cut to relieve pain. In a small percentage of patients, spinal instability may require that spinal fusion be performed.

Spinal fusion is an operation that creates a solid union between two or more vertebrae. This procedure may assist in strengthening and stabilizing the spine and may help to relieve severe and chronic neck pain.

There are a variety of the different types of lumbar fusions:

  • Transforaminal Lumbar Interbody Fusion:
    • allows surgeons to reduce nerve exposure by approaching the spine from the side, with a single incision in the back.
  • Transpsoas Interbody Fusion
  • Anterior Lumbar Interbody Fusion
  • Posterior Lumbar Interbody Fusion
  • Posterior Lateral Lumbar Fusion

Neck and Spine Regions

In medical terminology, the spine is divided into regions that correspond to their position along the vertebrae in the backbone. These sections are:

  • Cervical vertebrae in the neck (C1-C7)
  • Thoracic vertebrae in the upper back (T1-T12)
  • Lumbar vertebrae in the lower back (L1-L5)
  • Sacral vertebrae in the pelvic region (S1-S5)

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