Tethered Spinal Cord Syndrome (TCS): Symptoms & Treatment

Tethered spinal cord syndrome (TCS) refers to a group of neurological disorders that relate to malformations of the spinal cord.

In children, a tethered cord can force the spinal cord to stretch when they grow. In adults the spinal cord stretches in the course of normal activities, usually leading to progressive spinal cord damage if untreated.

TCS is often associated with the closure of a spina bifida. It can be congenital or the result of injury later in life.


TCS is related to many causes, including:

  • Spina bifida
  • History of spinal trauma
  • History of spinal surgery
  • Tumors in the spinal column
  • Thickened and/or tight filum terminale
  • Lipomas in the spinal column
  • Dermal Sinus Tract (congenital deformity)
  • Diastematomyelia (split spinal cord)

TCS is a disorder but not a mechanism so it won’t spread to other people, at the same time, there are no measures that can be done to prevent it beforehand.


In children, symptoms may include:

  • Lesions, hairy patches, dimples, or lipomas on the lower back
  • Foot and spinal deformities
  • Weakness in the legs (loss of muscle strength and tone)
  • Change in posture while walking or running
  • Low back pain
  • Scoliosis (abnormal curvature of the spine to the left or right)
  • Urinary irregularities (incontinence or retention)

In adults, symptoms typically including:

  • Severe pain (in the lower back and radiating into the legs, groin, and perineum)
  • Bilateral muscle weakness and numbness
  • Loss of feeling and movement in lower extremities
  • Urinary irregularities
  • Bowel control issues


In children, early surgery is recommended to prevent further neurological deterioration.

In adults, surgery to de-tether (free) the spinal cord can reduce the size and further development of cysts in the cord and may restore some function or alleviate other symptoms.

Although it is the common surgical approach to TCS, another surgical option for adults is a spine-shortening vertebral osteotomy. It aims to indirectly relieve the excess tension on the spinal cord by removing a portion of the spine, shortening it.

The disorder progresses with age, but with treatments, patients have a normal life expectancy though most neurological and motor impairments are irreversible.

Keywords: tethered spinal cord syndrome; TCS.

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.