Though more often developed in childhood, adult tethered cord syndrome can go undetected until later in life. Related to spina bifida, this condition is characterized by a spinal cord located in an abnormally low position within the spinal canal. Spine surgery is usually the preferred treatment if the condition is causing extreme discomfort.
Signs and Symptoms
The spinal cord is wrapped in a covering, or sheath, that allows bones and tissues to expand during childhood and adolescence. When the spinal cord becomes tethered, it’s attached to nearby tissues. Instead of moving along this covering, the spinal cord stretches. Tethered cord syndrome may not result in any symptoms early in life, but may become problematic later due to age-related changes in the spine, resulting in:
- Lower back pain aggravated by bending movements (flexion)
- Low back pain and weakness in the legs
- Dimples (fatty tumors) on the lower back
Tethered cord syndrome may be caused by improper fetal growth of a hollow structure where the brain and spinal cord form (neural tube). Sudden trauma or spinal surgery may also cause scar tissue to form and fix the spinal cord in place.
Diagnosis and Treatment
An MRI scan, which offers a closer look at soft tissues, can usually determine if the issue is an abnormal placement of the spinal cord rather than nerve compression. Diagnosis also includes looking for signs of a lower-than-normal spinal cord, which may be detected during an endoscopy. Treatment depends on the symptoms presented, and may involve:
- Surgery to detach the spinal cord from the sheath
- Pain or anti-inflammatory medication
- Physical therapy
- Activity modification
In some instances, what is thought to be adult tethered cord syndrome is actually a similar abnormality affecting the spine. Some patients may be misdiagnosed as having sciatica, a more common source of lower back and radiating pain. For this reason, diagnosis often includes a combination of medical history, presenting symptoms, and the elimination of other possible causes.
If you have tethered cord syndrome or another spine disorder and believe you might need surgery, reach out to The Spine Institute Center for Spinal Restoration. Dr. Bae specializes in spinal fusion surgery and motion-preserving spine procedures, and his expert team of surgeons can diagnose the source of your pain and determine the most effective form of treatment. Call 310-828-7757 today to request an in-person evaluation.