Tethered cord syndrome

Tethered cord syndrome is a neurological disorder caused by tissue attachments that limit the movement of the spinal cord within the spinal column. It can be congenital or acquired and appear in childhood or adulthood.

It causes spinal cord hypoperfusion and metabolic changes, including impaired glucose metabolism.

Symptoms

 * Leg pain
 * Leg weakness
 * Leg numbness
 * Lower back pain
 * Numbness under soles of feet
 * Rectal pain
 * Urinary urgency or incontinence
 * Urinary retention
 * Bowel dysfunction
 * Pulling sensation (on brain or upper spine, from below)
 * Scoliosis

=== Signs and symptoms in Children ===
 * Lesion on the lower back
 * Fatty tumor or deep dimple on the lower back
 * Skin discoloration on the lower back
 * Hairy patch on the lower back
 * Back pain, worsened by activity and relieved with rest
 * Leg pain, especially in the back of legs
 * Leg numbness or tingling
 * Changes in leg strength
 * Deterioration in gait
 * Progressive or repeated muscle contractions
 * Leg deformities
 * Spine tenderness
 * Scoliosis (curvature of the spine)
 * Bowel and bladder problems
 * Difficulty running

Metabolism
Tethered cord is associated with impaired glucose metabolism in spinal cord tissue.

Blood flow
People with tethered cord syndrome have reduced blood flow to the spinal cord.

In a study of five children undergoing surgery for tethered cord syndrome group, spinal cord blood flow prior to untethering was a mean of 12.6 ml/min per 100 g of tissue. It increased in all cases after release to a mean of 29.4 ml/min per 100 g of tissue.

Co-morbidities

 * Ehlers-Danlos syndrome
 * Craniocervical instability