Tethered Spinal Cord Syndrome (TSC) Treatment in Noida, Delhi Ncr, India

Overview

Tethered spinal cord syndrome (TSC) is a neurological disorder caused by tissue attachments that limit the movement of the spinal cord. It occurs when the spinal cord adheres to the surrounding tissue, typically at the base of the spine. This abnormal attachment can lead to the spinal cord stretching, resulting in complications such as nerve damage, severe pain, and other issues affecting daily activities and development, particularly in children. The condition is treatable, especially when diagnosed and managed early. Surgery is the most common treatment to detach the spinal cord from the surrounding tissue.

Symptoms

Symptoms of TSC can vary by age, and in some cases, children may not experience symptoms until they are older. Common symptoms in children include:

• A bump, hairy patch, or dimple on the lower back
• Discoloration in the lower back
• Unusual anatomy of the genitals and anus
• Uneven leg length
• Lower back pain
• Numbness and tingling in the legs
• Difficulty standing or walking
• Loss of bladder control

Early symptoms often go undiagnosed, leading to more severe issues such as bowel, sensory, motor, and bladder control problems. If untreated, the strain on the spinal cord may increase, causing long-lasting sensory and motor issues. Consulting a doctor is essential if a child or person shows any symptoms.

Causes

TSC can be congenital or develop after birth due to damage to the spinal cord or scar tissue from surgery. Other causes include:

• Spinal tumors
• Spina bifida
• Previous spinal surgery or scars
• History of spinal trauma

Diagnosis

Diagnosis depends on the age of the patient and includes examining symptoms, family medical history, and a physical examination of the lower back. Diagnostic methods include:

• MRI: Uses powerful magnets, high-energy radio waves, and specialized computer technology to produce a 3D image of the spine.
• CT scan: Provides accurate images of the spinal cord, muscles, bones, fat, and organs.
• Myelogram: Specialized test to diagnose spinal cord problems.
• Muscle test: Assesses body movements and physical strength.

Treatment

Early diagnosis might eliminate the need for surgery. Treatment options include:

• Surgery: Detaches the spinal cord from the surrounding tissue. A small incision is made, and the attached tissues are cut and released in steps. The procedure can take 3 to 6 hours.
• Physiotherapy: Personalized exercises to improve muscle strength and body movement.
• Medications: Non-steroidal anti-inflammatory drugs, painkillers, opiates, antidepressants, synthetic opiates, and seizure medications may be prescribed.
• Osteotomy: Surgical procedure to shorten the spine and relieve tension on the spinal cord, beneficial in preventing retethering.

Early surgical treatment is recommended for children to prevent neurological deterioration.

Risk Factors

Several factors can increase the risk of TSC, including:

• Tight filum terminale
• Split cord malformation
• Lipomeningomyelocele
• Dermoids
• Dermal sinus tract
• Myelocyctocele
• Genetic factors

TSC can also develop from infections, spinal tumors, or scar tissue from previous surgeries.

Prevention

There are no preventive measures for TSC, but timely medical intervention can prevent major complications and irreversible damage.

Complications

TSC and its surgical treatment can cause complications such as:

• Decreased muscle strength
• Side effects of anesthesia
• Excessive bleeding
• Spinal cord injury
• Infection
• Spinal fluid leakage
• Motor and sensory dysfunction

Prognosis

Timely treatment can stabilize and improve spinal cord function. Early diagnosis helps prevent motor function deterioration as the syndrome progresses with age. Medications and physiotherapy aid in recovery and enable a normal life.

Reviewed & Updated On: Reviewed by Dr. Akash Mishra, Sr. Consultant – Brain & Spine Surgeon on 02-July-2024.