Tethered cord syndrome

What it is

Tethered cord syndrome is a condition in which the spinal cord is abnormally fixed (tethered) to surrounding tissue at the lower spine, restricting its normal movement and stretching it. It can coexist with Chiari malformation and may need to be addressed as part of care.

Understanding Tethered cord syndrome

Normally, the spinal cord can move slightly within the spinal canal. In tethered cord syndrome, the cord is anchored abnormally (often at the lower end), which can stretch it and cause symptoms such as back or leg pain, weakness, sensory changes, and bladder or bowel problems. Tethered cord can occur in association with Chiari malformation (and with spina bifida), and in some cases addressing the tethered cord (through a surgical release, or detethering) is part of the overall management. When both conditions are present, the care team determines how to address each. Recognizing a tethered cord is important so it is not missed when evaluating a person with Chiari. Understanding tethered cord syndrome and Chiari clarifies a coexisting condition that may need its own treatment.

Why it matters

Understanding tethered cord syndrome and Chiari helps families see that abnormal fixation of the spinal cord can coexist with Chiari, cause its own symptoms, and may need to be addressed alongside the Chiari.