tethered cord syndrome

teth·ered cord syndrome (trd)

n.

Sacral retention of the spinal cord by the terminal filum, causing incontinence and progressive motor and sensory impairment in the legs.

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cord [kord]

any long, cylindrical, flexible structure; called also chord, chorda, and funiculus.

spermatic cord the structure extending from the abdominal inguinal ring to the testis, comprising the pampiniform plexus, nerves, ductus deferens, testicular artery, and other vessels.

spinal cord see spinal cord.

tethered cord a congenital anomaly resulting from defective closure of the neural tube; the conus medullaris is abnormally low and tethered by a short, thickened filum terminale, fibrous bands, intradural lipoma, or some other intradural abnormality. Surgical correction in infancy or early childhood is necessary to prevent progressive neurological deficit in the lower limb and bladder dysfunction.

umbilical cord see umbilical cord.

vocal c's see vocal cords.

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tethered cord syndrome

Neurology An occult spinal dysraphism due to a defect in dorsal induction, the earliest major embryologic process in forming the brain and spinal cord; during 2º neurulation, the neural tube atrophies and the ventral remnant persists as the filum terminale; as the vertebral column grows, the filum terminale and nerve roots lengthen; tethering results if the primitive sacral cord does not degenerate or the filum terminale and nerve roots do not lengthen properly Clinical-Children Static sensorimotor defects, deformities of spine and feet, skin changes in lumbosacral region–eg, hypertrichosis, hemangiomas, dimples; pain is rarely prominent Clinical-Adults Gait defects, upper and lower motor neuron signs, and either a spastic small-capacity bladder or less commonly, a hypotonic large-capacity bladder Diagnosis MRI; CT with intrathecal contrast, plain films, ultrasonography Treatment Laminectomy at appropriate lumbosacral level. Cf Neural tube defect.