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Tethered Cord Syndrome in Adults

Tethered cord syndrome is a rare progressive disorder. It results from tissue attachments that limit spinal cord movement within the spinal column. An example is spina bifida, a birth defect in which the spinal cord has not separated from the skin of the back during fetal development. Other types of tethered spinal cord syndrome also occur.

  1. Congenital Tethered Cord Syndrome

    • Tethered cord syndrome may be present at birth, but sometimes is not diagnosed until much later. Patients commonly experience symptoms during a growth spurt, but rarely, the disorder is not diagnosed until adulthood. At that point, previously minor symptoms may be aggravated by injury, disc herniation, stretching maneuvers or other activities affecting the back.

    Adult Tethered Cord Syndrome

    • Tethered spinal cord syndrome also can develop during adulthood. It can occur, for instance, if scar tissue after a spine injury or back surgery blocks fluid flow around the spinal cord, causing cysts to form. The syndrome also can result from a tumor or a benign growth called a lipoma.

    Symptoms

    • Symptoms in adults include leg pain, particularly in the back of the legs, leg numbness or tingling, muscle spasms, muscle weakness or atrophy in the legs and difficulty walking. The patient may experience pain in the foot arches and low back pain that becomes worse during activity. Changes in sensory abilities can result in bowel or bladder incontinence.

    Diagnosis

    • Diagnosis is usually made using magnetic resonance imaging (MRI). The prevalence of MRIs has led to an increase in diagnosis of tethered spinal cord syndrome in adults, who previously might have experienced progressive worsening of symptoms with no definitive diagnosis.

    Treatment

    • Physicians generally recommend that adults diagnosed with tethered cord syndrome have surgery to alleviate current symptoms and prevent further complications. Surgery also may restore some lost function. Convincing patients to have back surgery can be problematic, however, if the symptoms are not disabling.

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