Brain, Nervous System and Mental Conditions

Tethered Spinal Cord

What is a tethered spinal cord?

A tethered spinal cord is a disorder in which a child's spinal cord is pulled down and stuck, or fixed, to the spinal canal. The spinal cord normally floats free inside the spinal canal.

As a child grows, the spinal cord must be able to move freely inside the spinal canal. If the spinal cord is stuck, it will stretch like a rubber band as a child grows. This can permanently damage the spinal nerves.

Tethered Spinal Cord in Children

Children have tethered spinal cords for many reasons. But a tethered spinal cord most often occurs in children who have rare birth defects called myelomeningoceles or lipomyelomeningoceles. Over time, the spinal cords of children with these conditions may become stuck, or tethered, to the myelomeningocele or lipomyelomeningocele. This pulls on the spinal cord as the child grows, causing symptoms.

A child also may have a tethered spinal cord if:

  • The very end of their spinal cord is held down abnormally tight (filum terminale).
  • There is a small, abnormal tract going into the spinal canal from the skin (dermal sinus tract).
  • The spinal cord is split into two cords near the end (diastematomyelia or diplomyelia).
  • The child has a dermoid cyst or spine tumor.

Tethered Spinal Cord at Seattle Children's

Our neurosurgeons have a great deal of experience treating both tethered spinal cords and the underlying conditions that can cause them. We know that permanent damage to a child's spinal cord can result in loss of function if the problem is not treated. We operate on about 40 to 50 children a year who have some form of tethered spinal cord.

We use& neuromonitoring during surgery. This lets our neurosurgeons monitor the nerves and muscles of the lower part of your child's body during surgery. It helps neurosurgeons avoid the risk of further damaging your child's nerves.