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A tethered cord, however, is held taut at the end or at some point in the spinal canal. In children, a tethered cord can force the spinal cord to stretch as they grow. In adults the spinal cord stretches in the course of normal activity, usually leading to progressive spinal cord damage if untreated. [1]
In adults, surgery to free (detether) the spinal cord can reduce the size and further development of cysts in the cord and may restore some function or alleviate other symptoms. Tethered Cord Syndrome is causally linked to Chiari Malformation and any affirmative diagnosis of TCS must be followed by screening for Chiari's several degrees.
In a split cord malformation, some portion of the spinal cord is divided into parallel halves. The thecal sac may be divided and surround each half with a spike of cartilage or bone dividing the halves (Type I), or both halves may be present within the same sac where the dura is bound to a band of fibrous tissue (Type II).
Lumbosacral adult diastematomyelia is even rarer. Bony malformations and dysplasias are generally recognized on plain x-rays. MRI scanning is often the first choice of screening and diagnosis. MRI generally give adequate analysis of the spinal cord deformities although it has some limitations in giving detailed bone anatomy.
Magnetic resonance myelography (MR myelography or MRI myelography) is a noninvasive medical imaging technique that can provide anatomic information about the subarachnoid space. It is a type of MRI examination that uses a contrast medium and magnetic resonance imaging scanner to detect pathology of the spinal cord , including the location of a ...
It is frequently co-morbid with atlanto-axial joint instability, Chiari malformation, [3] or tethered spinal cord syndrome. The condition can be brought on by physical trauma , including whiplash , laxity of the ligaments surrounding the joint, or other damage to the surrounding connective tissue.
The spinal cord lesion or the scarring due to surgery may result in a tethered spinal cord. In some individuals, this causes significant traction and stress on the spinal cord and can lead to a worsening of associated paralysis, scoliosis , back pain, and worsening bowel and/or bladder function.
Sectional organization of spinal cord. The spinal cord is the main pathway for information connecting the brain and peripheral nervous system. [3] [4] Much shorter than its protecting spinal column, the human spinal cord originates in the brainstem, passes through the foramen magnum, and continues through to the conus medullaris near the second lumbar vertebra before terminating in a fibrous ...