Repair of congenital spine and spinal cord abnormalities

Cohen Children’s is a regional leader in pediatric neurology and neurosurgery. Our neurosurgeons perform repairs of congenital spine and spinal cord abnormalities, including the surgical treatment of tethered spinal cord. We usually perform this procedure if the patient is experiencing severe pain, loss of muscle function, worsening gait and/or changes in bladder or bowel function.

If a patient’s spinal cord “tethered,” it means that the nerve tissue may be under too much tension. Our surgeons can make an incision in the back and release the spinal cord from this tension. A small portion of the lumbar or sacral bone is removed to obtain exposure to the lining of the spinal cord. This is followed by the identification of the filum terminale at the end of the spinal cord and subsequently the surgical release of tension. The end result is the release of the spinal cord, so it can move freely within the spinal column. Without the operation, the spinal cord may continue to be under tension, causing worsening symptoms and possibly long term nerve damage.

Tethered spinal cord syndrome is a neurological disorder caused by tissue attachments that limit the movement of the spinal cord within the spinal column. These attachments cause an abnormal stretching of the spinal cord.

The preparation will differ for each treatment technique, and it’s usually minimal. Your doctor will discuss the specifics with you one-on-one.

The neurosurgeon will determine how long the patient needs to stay in bed, depending on their age, cause of the tethering and other factors. Before patients return home, they should be able to get up and out of bed, eat and drink, and urinate and have bowel movements without difficulty.  Oral medication will likely be prescribed to help manage pain, and patients typically resume normal activities within a few weeks.

It’s important to note that a tethered spinal cord release prevents symptoms from worsening, but it doesn’t correct spinal cord damage that has already occurred. In some cases, however, symptoms experienced before surgery have improved or resolved after surgery.

Patients may need to return for checkups throughout childhood and adolescence to monitor for recurrent tethering.