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What is a tethered cord?

A tethered cord means that the spinal cord cannot move freely in the spinal column. When the child bends and moves, the spinal cord is stretched because it is attached to the lower end of the spinal column. 

This stretching can cause:

  • Back, leg or foot pain

  • Loss or change of strength in the legs

  • Leg numbness or tingling

  • Loss or change in bladder or bowel control

  • Scoliosis getting worse (abnormal curve of the spine)

They often get worse. At first, they are slow to appear and are hardly noticed. They often last a lifetime.  A tethered cord can happen at any time during childhood or as an adult. 

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Causes of tethered cord

  • A past operation, such as repair of spina bifida, can build up scar tissue in the spine. The scar tissue causes the spinal cord to stick to the lower end of the spinal column.

  • Some spinal cord problems that are present at birth may cause the cord to be fixed to the tissue around it. Such problems include: a fat mass, a double spinal cord (split cord malformation), or a spinal cord tumor. These problems cannot be seen when looking at the child, but often there are clues found in the skin lying over the problems. You may notice a tuft of hair, a birth defect, a tiny hole, a skin tag, or a mass under the skin.

Treatment for tethered cord

All tethered cord patients need surgery to prevent further problems related to nerve damage. Surgery involves gently releasing the spinal cord from the tissue that it is stuck to. By making a cut in the skin, removing some bone from the spine so the spinal cord is exposed. Risks include more problems with the bladder and bowels and more weakness in the legs.

Before Surgery

  • Have a physical exam and lab tests that include blood work and urinalysis.

  • Make this appointment with your primary care provider or with a nurse in our department.

  • Complete this within 30 days of surgery. We may cancel surgery without an updated pre-operative exam.

  • Contact your insurance company for any referrals you may need

  • Stop the following medicines for two weeks before surgery. 

    • Aspirin, Excedrin®, Ascriptin®, and Ecotrin®

    • Vitamins and herbal supplements

    • Plavix®

    • Coumadin® or Warfarin

    • Ibuprofen, Advil®, Motrin®, Nuprin®, and Aleve® 

  • You may use acetaminophen (Tylenol®®) if needed.

No smoking or exposure to cigarette smoke for two weeks prior to surgery. Smoking delays wound healing and contains a poison that lowers the level of oxygen in the blood. 

See the HFFY “getting your skin ready for surgery” for bathing instructions.

After midnight the night before surgery

  • Do not eat anything

  • Do not drink any milk or juice with pulp

  • You may drink clear liquids up until 4 hours before surgery

You will be called the afternoon before surgery. At this time you will be told

  • What time you need to arrive at the hospital final details about how to get ready for the next day.

  • You will need to sign a consent form. The consent states that you understand what was explained to you about the procedure. It states that you know about the risks and benefits of the surgery.

  • Do not wear make-up, jewelry, or nail polish to surgery. 

After Surgery

  • After surgery, plan to stay flat for 24 hours to reduce the chance of a CSF (cerebral spinal fluid) leak from the incision. 

  • Your child may also have muscle spasms or pain. Pain medicine will be given to help. 

  • Plan for at least 3 to 5 days in the hospital.

  • A follow-up appointment will be scheduled in the neurosurgery clinic in 7-10 days. The back dressing and stitches will be removed at that time. 

  • Please keep the dressing clean and dry. Your child should avoid twisting, pulling, stretching or straining her back until you are told this is allowed.

When to call

You should call the neurosurgery office if you have any questions about the surgery or the symptoms your child may have. Please check the incision twice a day until it is healed. If the incision becomes infected, call right away. Signs of infection are:

  • Fever greater than 101.5° F

  • Any redness, swelling, or drainage from the incision 

Phone Numbers 

American Family Children’s Hospital Clinic: (608) 263-6420.

After hours, weekends, and holidays, call the paging operator at (608) 262-0486. Ask for the neurosurgeon on call. Give your name and phone number with the area code. The doctor will call you back. If you live out of the area, call 1-800-323-8942.