Tethered Cord

A tethered cord is when the spinal cord cannot move freely in the spinal column. When the child bends and moves, the spinal cord is stretched. This stretching may cause:

• Loss or change in bladder or bowel control.

• Pain, numbness or tingling in the back, legs or feet.

• Scoliosis getting worse (abnormal curve of the spine).
  

Symptoms may get worse over time. At first, they are slow to appear and are hardly noticed. Symptoms can happen at any time during childhood or as an adult.

Causes
A tethered cord could be caused by built up scar tissue in the spine from a past surgery.

Some spinal cord problems that are present at birth may cause the cord to be fuse to the tissue around it. These problems cannot always be seen when looking at the child. Often there are clues found in the skin lying over the spine. You may notice:

• a tuft of hair

• a tiny hole

• a skin tag

• a mass under the skin.
  

Treatment
Patients need surgery to prevent further nerve damage. Surgery involves gently releasing the spinal cord from the tissue that it is stuck to by making a cut in the skin to remove some of the bone from the spine.

Before Surgery
You will need to have a physical exam and lab tests. Complete this within 30 days of surgery or we may need to cancel the surgery.
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 before surgery.

We will call the afternoon before surgery. You will be told what time you need to arrive at the hospital and final details about getting ready for surgery.

Day of Surgery
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 the day of surgery.

After Surgery
Plan for at least 2 to 5 days in the hospital. You will need to lay flat for 24 hours to reduce the chance of cerebral spinal fluid leaking from the incision.

Muscle spasms or pain are common after surgery. Pain medicine will be given to help.

Keep the dressing clean and dry. Check the incision for infection twice a day until it is healed. Signs of infection include:

• Fever above 101.5 F

• Redness, swelling, or drainage from the incision
  

Avoid twisting, pulling, stretching or straining the back until you are told it is okay.

Follow Up
You will have a follow-up visit scheduled in the neurosurgery clinic in 7-10 days. The back dressing and stitches will be removed at that time.

When to Call
Call if you have any questions about the surgery. If the incision becomes infected, call right away.

Who to Call
Pediatric Neurosurgery Clinic
American Family Children’s Hospital Clinic (608) 263-6420 or 1-800-323-8942

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.