Tethered (Spinal) Cord Syndrome can be congenital or acquired. It occurs when fibrous tissues connect to the spinal cord or Filum Terminale and creates a downward pulling on the cord (often stretching the cord itself). Tethering can happen anywhere in the spinal column, but more often occurs in the lumbar region. Tethered Cord Syndrome can cause an Acquired Chiari Malformation.
Symptoms: Neurogenic Bladder (urgency, overactive bladder, incontinence, problems starting urinary stream, problems emptying bladder, reoccurring Urinary Tract Infections); Constipation/Diarrhea; Bowel Incontinence; Sexual Dysfunction (decreased sensation to pelvic area, decreased sexual interest, difficulty reaching orgasm); Bowel Incontinence; Severe Lower Back Pain (worsened by activity); Leg Pain/Numbness and/or Muscle Wasting (atrophy); Scoliosis.
Identifying Markers Often Include: Sacral Dimple; High-arched Feet; Hammertoes; low Medulla Oblongata (MRI); Low Conus (to the L2/L3); Thick-short Filum Terminale, Diastematomyelia (part of the spinal cord is split), Intradural Lipomas (fatty accumulation inside the dura) and Lipomyelomeningocele. Sometimes, signs of Tethered Cord are NOT visible on MRI, they are then referred to as Occult Tethered Cord; in such cases, Tethered Cord Release is considered controversial amongst many surgeons.