Tethered Spinal Cord

A tethered spinal cord is a spinal cord that is tied down or ‘tethered’ to tissues at the bottom end of the spinal column, preventing the spinal cord from moving freely. Before birth, a baby’s spinal cord and spinal column (vertebrae surrounding the spinal cord) are roughly the same length. As the baby grows, the spinal column gets longer than the spinal cord, allowing the latter to move freely inside the column of vertebrae. In babies with tethered cords, this free movement of the spinal cord is not possible because the tail-end of the spinal cord is attached to the tissues around the spine. As the child grows, the spinal cord is stretched, which causes problems with nerve function as the nerves also get stretched with the spinal cord.

A tethered cord can occur due to congenital abnormalities, such as spina bifida (incomplete closure of spinal cord at birth), or due to the development of abnormal fibrous tissue to which the spinal cord may get tethered. Other factors may include tumours, infection of the spinal cord, trauma to the spine, growth of a fatty piece of skin into the spine (dermoid or epidermoid) or a complication of spinal surgery.

It occurs more commonly in children, and is less frequently observed in adults and adolescents. 

When to seek expert advise

If left untreated, tethered cord can also cause nerve damage which may be irreversible. Early diagnosis and treatment is important for ensuring the maximum possible recovery for your child. If you notice the signs and symptoms of tethered cord in your child, discuss this with a paediatric neurologist working with the Mind and Brain Service Line​ of The Aga Khan University Hospital.​​​​