Skip to main content
SpringerLink
Log in
Book cover

The Spina Bifida pp 275–280Cite as

Pathophysiology and Clinical Features of Tethered Cord Syndrome

  • Chapter

  • 4379 Accesses

Abstract

The proposed normal function of the terminal filum of the spinal cord is to fixate, stabilize and buffer the distal cord from normal and abnormal cephalic and caudal traction. The filum is a viseoelastic band that usually allows the conus medullaris to move slightly during flexion and extension of the spine. It is theorized that if the viscoelasticity of the filum is lost or compromised by fatty infiltration [1] or abnormal thickening, then caudal tension and traction may cause stress upon the conus, resulting in a tethered spinal cord (TSC).

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Dubowitz V, Lober J, Zachary RB (1965) Lipoma of the cauda equine. Arch Dis Child 40:207–213

    Article  PubMed  CAS  Google Scholar 

  2. Hogg ID (1941) Sensory nerves and associated structures in the skin of human fetuses of 8 to 14 weeks of menstrual age correlated with functional capability. J comp Neurol 75:371–410

    Article  Google Scholar 

  3. Hendrick EB, Hoffman HJ, Humphreys RP (1983) The tethered spinal cord. Clin Neurosurg 30:457–463

    PubMed  CAS  Google Scholar 

  4. Metcalfe PD, Luerssen TG, King SJ et al (2006) Treatment of the occult tethered spinal cord for neuropathic bladder: results of sectioning the filum terminale. J Urol 176:1826–1829; discussion 1830

    Article  PubMed  CAS  Google Scholar 

  5. Drake JM (2006) Occult tethered cord syndrome: not an indication for surgery. J Neurosurg 104:305–308

    Article  PubMed  Google Scholar 

  6. Selden NR (2006) Occult tethered cord syndrome: the case for surgery. J Neurosurg 104:302–304

    PubMed  Google Scholar 

  7. Wehby MC, O’Hollaren PS, Abtin K et al (2004) Occult tight filum terminale syndrome: results of surgical untethering. Pediatr Neurosurg 40:51–57

    Article  PubMed  Google Scholar 

  8. Huse T, Patrickson JW, Yamada S (1989) Axonal transport of horse-radish peroxidase in the experimental tethered spinal cord. Pediatr Neurosci 15:196–301

    Google Scholar 

  9. Kang JK, Kim MC, Kim DS, Song JU (1987) Effects of tethering on regional spinal cord blood flow and sensory — evoked potentials in growing cats. Childs Nerv Syst 3:35–39

    Article  PubMed  CAS  Google Scholar 

  10. Koca KA, Kilie A, Nurlu G et al (1997) A new model for tethered cord syndrome: a biochemical electrophysiological and electron microscopic study. Pediatric Neurosurg 26:120–126

    Article  Google Scholar 

  11. Tani S, Yamada S, Knighton RS (1987) Extensibility of the lumbar and sacral cord. Pathophysiology of the tethered spinal cord in cats. J Neurosurg 66:116–123

    PubMed  CAS  Google Scholar 

  12. Yamada S, Iacono RP, Androde T et al (1995) Pathophysiology of tethered cord syndrome. Neurosurg Clin N Hm 6:311–323

    CAS  Google Scholar 

  13. Selcuki M, Vatansever S, Inan S et al (2003) Is a filum terminale with a normal appearance really normal? Childs Nerv Syst 19:3–10

    PubMed  Google Scholar 

  14. Hoffman HJ, Hendrick EB, Humphreys RP (1976) The tethered spinal cord: its protean manifestations, diagnosis and surgical correction. Childs Brain 2:145–155

    Article  PubMed  CAS  Google Scholar 

  15. Sostrin RD, Thompson JR, Rouhe SA (1977) Occult spinal dysraphism in the geriatric patient. Radiology 125:165–169

    PubMed  CAS  Google Scholar 

  16. Pool JL (1952) Spinal cord and local signs secondary to occult sacral meningoceles in adults. Bull NY Acad Ned 28:655–663

    CAS  Google Scholar 

  17. Hilal SK, Keim HA (1972) Selective spinal angiography in adolescent scoliosis Radiology 102:349–359

    CAS  Google Scholar 

  18. Tubbs RS, Oakes WJ (2004) Can the conus medullaris in normal position be tethered? Neurol Res 26:727–731

    Article  PubMed  Google Scholar 

  19. Yamada S, Sanders D, Maeda G (1981) Oxidative metabolism during and following ischemia of cat spinal cord. Neurol Res 3:1–16

    PubMed  CAS  Google Scholar 

  20. Yamada S, Knerium DS, Mandybur GM et al (2004) Pathophysiology of tethered cord syndrome and other complex factors. Neurol Res 26:722–726

    Article  PubMed  Google Scholar 

  21. Pang D (1985) Tethered cord syndrome in adults. In: Holtzman RNN, Stein BM (eds) The tethered spinal cord. Thieme-Stratton, New York, pp 99–115

    Google Scholar 

  22. Kang J-K (2000) In: Matsumoto S, Sato H (eds) Spina Bifida. Springer-Verlag Tokyo, pp 131–137

    Google Scholar 

  23. Joned PH, Love JG (1956) Tight filum terminale. Arch Surg 73:556–566

    Google Scholar 

  24. Pang D, Wilberger JE Jr (1982) Tethered cord syndrome in adults. J Neurosurg 57:32–47

    PubMed  CAS  Google Scholar 

  25. Pang D (1992) Split cord malformation: Part II: clinical syndrome. Neurosurgery 31:481–500

    Article  PubMed  CAS  Google Scholar 

  26. Pang DC (1995) Spinal cord syndrome. In: Pang D (ed) Disorders of the pediatric spine. Raven Press, New York, pp 175–201

    Google Scholar 

  27. Pang D (1991) Tethered cord syndrome: newer concepts. In: Wilkins RH, Rengachary SS (eds) Neurosurgery update II. McGraw-Hill, New York, pp 336–344

    Google Scholar 

  28. Blaivas JG (1985) Urological abnormalities in the tethered spinal cord. In: Holtzman RNN, Stein BM (eds) The tethered spinal cord. Thieme-Stratton, New York, pp 59–73

    Google Scholar 

  29. McGuire, EJ, Woodside JR, Borden TA (1981) Prognostic value of urodynamic testing in myelodysplastic patients. J Urol 126:205–209

    PubMed  CAS  Google Scholar 

  30. Blaivas JG, Sinha HP, Zayed AA, Labib KB (1981) Detrusor-external sphincter dyssynergia. J Urol 125:542–544

    PubMed  CAS  Google Scholar 

  31. Breig A (1970) Overstretching of and circumscribed pathological tension in the spinal cord: a basic cause of symptoms in cord disorders. J Biomech 3:7–9

    Article  PubMed  CAS  Google Scholar 

  32. Pang D (1986) Tethered cord syndrome. In: Hoffman HG (ed) Advances in pediatric neurosurgery (Neurosurgery: State of the art reviews. Vol 1, no 1) Hanley’ s Beefus, Philadelphia, pp 45–79

    Google Scholar 

  33. Hoffman HJ (1985) The tethered spinal cord. In: Holtzman RNN, Stein BM (eds) The tethered spinal cord. Thieme-Stratton, New York, pp 91–98

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery Catholic University Medical College, Kangnam St. Peter’s Hospital, Seoul, Korea

    Joon-Ki Kang

Authors
  1. Joon-Ki Kang
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Springer-Verlag Italia

About this chapter

Cite this chapter

Kang, JK. (2008). Pathophysiology and Clinical Features of Tethered Cord Syndrome. In: The Spina Bifida. Springer, Milano. https://doi.org/10.1007/978-88-470-0651-5_23

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-0651-5_23

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0650-8

  • Online ISBN: 978-88-470-0651-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation