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Tethered Cord

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Tethered Cord

  • 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
  • Symptoms
  1. Low Back Pain
    1. Worse with Exercise
  2. Leg Weakness
  3. Urinary Incontinence
  • 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
  • Imaging
  • Management
  1. Consult Neurosurgery