What Is a Tethered Spinal Cord, and How Is It Treated?

A tethered spinal cord occurs when the lower part of the spinal cord attaches to the meninges (the membrane around the cord). This keeps the cord from being able to move freely. As a child grows and moves around, the spinal cord gets stretched and pulled, and this can cause problems with pain and movement.

Children with spina bifida often have some tethering but may not need treatment unless they have symptoms. Other causes of a tethered spinal cord may include injury or infection to the spine, spinal surgery, or a tumor on the spine.

Symptoms vary from child to child and depend on how severely the spinal cord is tethered. Symptoms may include:

  • A lesion, dimple or patch of hair on the lower back
  • Changes in the growth of the spine or feet
  • Foot deformities, such as clubfoot or hammer toes
  • Pain or weakness in the legs or back
  • A numb or tingling feeling in the legs
  • Trouble walking that worsens over time or with activity that improves with rest
  • Scoliosis
  • Changes in bladder and bowel control

Symptoms may appear in infants, children or later in life during adulthood. When symptoms appear, treatment depends on how severe the symptoms are or how symptoms progress.

How is a tethered spinal cord diagnosed?

Your child’s doctor will determine whether he has a tethered spinal cord by ordering a series of medical tests, including:

  • X-ray
  • Ultrasound
  • CT scan
  • MRI
  • Muscle tests to check for movement, feeling and strength
  • Tests to check the kidneys and bladder

Symptoms may worsen over time. Damage to the spinal cord can occur if surgery is not performed. Your child’s doctor will talk with you about the risks, benefits and complications of surgery.

How is a tethered spinal cord treated?

At Children’s Healthcare of Atlanta, our pediatric spine specialists may advise that your child undergo surgery early on, which can sometimes help prevent new symptoms and damage. If your child’s legs and back were weak before surgery, physical therapy can sometimes improve muscle strength or movement. Some children may need more surgeries as they grow. Routine follow-up visits are important to check healing and help make sure re-tethering does not occur.

When should I contact the doctor?

Call your child’s doctor if you have any concerns about how he looks or feels.

After your child has surgery, call your child’s doctor or go to the nearest emergency department right away if he has:

  • Signs of infection at the surgery site, such as drainage or a bad smell, increased redness, warmth, or tenderness.
  • A temperature higher than 100.4°F, or 38°C.
    • Any problems or symptoms that return or get worse after surgery, such as:
    • Weakness or numb or tingling feelings in the legs or feet
    • Change in bladder or bowel control
    • Trouble walking or moving
    • Pain not relieved by pain medicine