Yesterday Grey’s Anatomy came back for another season, and so does this column, where we teach you about a disease featured on each episode. This time – tethered spinal cord syndrome.

Danger level: High

Health forums category: Children’s Diseases

What is it?

Tethered cord syndrome (TCS)  is a condition which limits the movement of the spinal cord within the spinal column.

Who gets it?

TCS is a rare disease – it happens in about 0.05-0.25 of 1000 births.

There is, however, a more common condition called spina bifida, which happens to 1-2 people out of 1000. About 20-50% of children born with spina bifida have TCS. Spina bifida, in case you’re wondering, is a condition in which the bones of the spine (the vertebrae) do not form properly during pregnancy.

What causes it?

To understand TCS, you have to know how our spine is built.

In our back there is a row of bones (vertebrae), which together form our spine. Inside these bones travels a cord, called the spinal cord. The spinal cord is responsible for sending messages from our brain (where it starts) to the rest of our body, and by this it controls movement and sensation in the body.

The lower tip of the spinal cord is called the conus medullaris. During development in the womb, the spinal cord moves up in the spine. In TCS, it stops in the middle of the way, so that the conus medullaris is lower in the spinal cord than it should be. In this case, it is tethered, and doesn’t float freely.

When a child that has tethering of his lower spinal cord starts growing, the spinal cord, which is still tethered, starts stretching. This can cause damage to the spine and interfere with the blood supply to it.

How does it feel?

There are several things which TCS can cause:

1. Back pain – It’s usually worsened by activity and relieved by rest.
2. Leg pain – Especially in the back of the legs.
3. Leg numbness or tingling
4. Changes in the strength of the legs
5. Difficulty riding a bicycle, playing sports and falling while running.
6. Muscle contractions
7. Tenderness along the spine
8. Scoliosis – This is a condition in which the spine grows crooked.
9. Problems with urinating

And others…

How is it discovered?

MRI – This is a technique in which an x-ray image of the spine is taken. This is the best way to detect TCS.

How is it treated?

TCS is usually treated with surgery, in which the cord is released so that it is no longer tethered.

This video shows the part in the surgery where the cord is released:

What happens after treatment?

With treatment, the problems should disappear.

Without surgery, though, the condition can get worse. As the child keeps growing and the spine keeps stretching, the blood vessels supplying it get damaged, and less blood is transferred to the cord. This can lead to further damage to the cord and deterioration of the condition.

As mentioned above, TCS often coexist with a condition called spina bifida. There are certain things you can do to lower your baby’s risk for having spina bifida, and by this lowering its risks for TCS:

1. Take folic acid during pregnancy. Foods rich in folic acid contain avocados, black beans, and asparagus. The best way to obtain it, though, is by taking a pill supplement. Consult your doctor for the recommended dosage.
2. If you take drugs to treat seizures or acne, you should consult your doctor before getting pregnant, as those can cause birth defects.
3. Avoid getting too hot in the first weeks of pregnancy (such as in a sauna, a very hot bath, or when you have high fever) – The heat may raise the risk for spina bifida.

What next?

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