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Tethered cord syndrome (TCS) refers to a group of neurological disorders that relate to malformations of the spinal cord. [1] Various forms include tight filum terminale , lipomeningomyelocele , split cord malformations ( diastematomyelia ), occult, dermal sinus tracts , and dermoids .
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.
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.
Other conditions sometimes causally associated with Chiari malformation include hydrocephalus, [49] syringomyelia, spinal curvature, tethered spinal cord syndrome, and connective tissue disorders [42] such as Ehlers–Danlos syndrome [50] and Marfan syndrome. Chiari malformation is the most frequently used term for this set of conditions.
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 ...
Photos: Pearl Harbor on Dec. 7, 1941. Ford Island is seen in this aerial view during the Japanese attack on Pearl harbor December 7, 1941 in Hawaii. The photo was taken from a Japanese plane.
The lumbar cistern is part of the subarachnoid space.It is the space within the thecal sac which extends from below the end of the spinal cord (the conus medularis), typically at the level of the first to second lumbar vertebrae down to tapering of the dura at the level of the second sacral vertebra.