Release of Tethered Spinal Cord

SURGERY TO FREE A TETHERED SPINAL CORD.

child getting ready to undergo tethered spinal cord release surgery

Although the spinal cord normally floats freely inside the spinal canal, a tethered spinal cord occurs when the spinal cord is pulled down and stuck, or fixed, to 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 cause lasting damage to the spinal nerves.

A child can have a tethered spinal cord for many different reasons, but it most often occurs in children with birth defects such as myelomeningoceles or lipomyelomeningoceles. Other causes can include:

The very end of the spinal cord is held down more tightly than normal
There is a small tract that is not normal, going from the skin into the spinal canal
The spinal cord is split into two cords near the end

Surgical Procedure

To free the spinal cord, BSSNY pediatric neurosurgeons will perform a laminectomy. In this procedure, they remove one or more parts of bones in the spine (vertebrae) in order to reach the spinal cord, the spinal nerve roots, and the thecal sac around the spinal cord. The neurosurgeon will then free the spinal cord by gently cutting, or teasing, it away from the scar tissue or fat. Neurosurgeons will use a microscope to help them see the area during the surgery.

After the spinal cord is free, neurosurgeons sometimes apply a patch to the covering of the spinal cord to prevent the cerebrospinal fluid from leaking.

There is a risk that the spinal cord may become re-tethered at a later time, so ongoing monitoring is necessary.