II. Pathophysiology

  1. Progressive, limited movement of spinal cord within spinal canal
  2. Tissue attachments to spinal cord prevent its movement
    1. Acquired
    2. Congenital
      1. Filum Terminale is typically a fine, thread-like attachment anchoring the spinal cord to the Coccyx
      2. A thickened Filum Terminale may result in a congenital Tethered Cord

III. Symptoms

  1. Low Back Pain
    1. Worse with Exercise
  2. Leg Weakness
  3. Urinary Incontinence

IV. Signs

  1. Scoliosis
  2. Lower extremity sensory loss in Dermatome distribution
  3. Lower Extremity Lower Motor Neuron Deficits
    1. Calf muscle atrophy
    2. Weak ankle dorsiflexion
    3. Hyporeflexia

V. Imaging

VI. Management

  1. Consult Neurosurgery

Images: Related links to external sites (from Bing)

Related Studies

Ontology: Tethered Cord Syndrome (C0080218)

Definition (NCI) A progressive neurological disorder characterized by the limitation of movement of the spinal cord within the spine. It is caused by the presence of congenital or acquired tissue attachments in the spinal cord. Signs and symptoms include low back pain, scoliosis, weakness in the legs, and incontinence.
Concepts Disease or Syndrome (T047) , Congenital Abnormality (T019)
MSH D009436
SnomedCT 70534000
English Tethered Cord Syndromes, Tethered cord, tethered cord syndrome, tethered cord syndrome (diagnosis), cord syndrome tethered, Spinal Dysraphism, Occult, Occult Spinal Dysraphism Sequence, Occult Spinal Dysraphism, Occult Spinal Dysraphisms, Dysraphism, Occult Spinal, Spinal Dysraphisms, Occult, Tethered Spinal Cord Syndrome, Dysraphisms, Occult Spinal, Tethered Cord Syndrome, Spinal Cord Syndrome, Tethered Cord, Occult spinal dysraphism sequence, Tethered cord malformation sequence, Tethered cord syndrome, Occult spinal dysraphism sequence (disorder), Congenital tethering of spinal cord
Dutch tethered cord-syndroom, Neuralebuisdefect
French Syndrome du cordon fixé, Syndrome de la moelle fixée
German Tethered-spinal-cord Syndrom, Syndrom des gefesselten Rückenmarks
Italian Sindrome della spina bifida, Sindrome da midollo ancorato
Portuguese Síndrome da medula acorrentada, Síndrome da Medula Presa
Spanish Síndrome de médula anclada, Síndrome de la Médula Anclada, secuencia de disrafismo espinal oculto (trastorno), secuencia de disrafismo espinal oculto
Japanese 脊髄係留症候群, セキズイケイリュウショウコウグン
Czech Syndrom fixované míchy, okultní spinální dysrafismus
Hungarian Letapadt gerincvelő syndroma
Norwegian Tjoret ryggmarg, Tethered cord