What is Tethered Cord Release?
Tethered cord syndrome is a condition characterized by a restricted spinal cord within the spinal canal that cannot move upward with growth, causing stretching or damage to the spinal cord. A tethered cord release is a procedure to free the spinal cord from tissue that holds it in place.
Preparation for Tethered Cord Release
Pre-operative preparation for tethered cord release includes:
- A thorough history and neurological physical examination in which a neurosurgeon will assess how the nerves and reflexes are working
- Other tests such as an MMT which measures lower body strength, MRI of the spine and sometimes the head, spine x-rays, and urodynamic testing which shows how well the bladder empties and fills
Tethered Cord Release Procedure
Surgery is the main treatment for tethered cord syndrome. Immediate intervention helps improve recovery chances and can prevent further functional decline.
The surgery is performed under general anesthesia. Once the site is prepared, your surgeon will make an incision in the skin over the lower back, followed by lifting the bone over the tethered area of the spinal cord. The next step involves making a small opening in the outer covering of the spinal cord, called the dura. Your surgeon then releases the tethering lesion, which may require many hours to accomplish. At times, a laser to sharply dissect tissue from the nerves may also be used. Once the spinal cord is untethered and free, the instruments are removed, and the surgical incision is closed with absorbable sutures.
Treatment helps you to have a normal life expectancy. However, some motor impairments and neurological problems may not be fully correctable.
Post-operative Care for Tethered Cord Release
After the surgery, you will need to lie flat on your back for up to 72 hours to prevent cerebrospinal fluid (CSF) from leaking around the spinal cord. The general post-operative care and instructions involve:
- You will be transferred to the recovery area to be monitored until you are awake from the anesthesia.
- Your nurse will monitor your blood pressure and other vital signs as you recover as well as nerve function, such as leg movement and urine control.
- Pain medications will be prescribed for comfort.
- Antibiotics will be administered to prevent infection.
- Physical therapy and an exercise regimen will be gradually started to enhance the range of motion.
- Instructions on surgical site care and bathing will be provided prior to discharge.
- You should keep all scheduled follow-up appointments to monitor your progress.
Risks and Complications of Tethered Cord Release
Tethered cord release is a relatively safe procedure; however, as with any surgery, there may be some risks and complications associated with it, such as:
- Anesthetic complications
- Spinal cord damage
- Problems with muscle strength, or bowel or bladder function
- Possibility of a repeat procedure if the spinal cord reattaches to tissue