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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.
Causes of this negative or pulling pressure include a tethered cord or an excessively tense Filum terminale, a cerebrospinal fluid leak creating a negative pressure around the spinal cord as the fluid surrounding the cord leaks out, or a CSF-venous fistula, in which the CSF leaks into a nearby vein. [10] [20]
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.
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).
McDermott says she sees many adults overestimate their ability and skip warmups, which increases the risk of injury. These include muscle strains, sprained ankles, torn ligaments or fractures.
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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.