{"id":141953,"date":"2019-05-09T00:00:13","date_gmt":"2019-05-08T22:00:13","guid":{"rendered":"https:\/\/institutchiaribcn.com\/?post_type=enfermedades&p=141953"},"modified":"2026-03-26T13:00:36","modified_gmt":"2026-03-26T12:00:36","slug":"tethered-cord-spina-bifida-meningocele-myelomeningocele-tethered-cord-syndrome","status":"publish","type":"enfermedades","link":"https:\/\/institutchiaribcn.com\/en\/tethered-cord-spina-bifida-meningocele-myelomeningocele-tethered-cord-syndrome\/","title":{"rendered":"Tethered cord with spina bifida – meningocele or myelomeningocele – or Tethered Cord Syndrome"},"content":{"rendered":"

Last update: 17\/06\/2020, <\/strong>Dr. Miguel B. Royo Salvador<\/strong><\/a>, Medical Board number 10389.<\/strong> Neurosurgeon y Neurologist.<\/strong><\/p>\n

Definition<\/strong><\/h2>\n

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In normal conditions, the spinal cord is held within the spinal canal only by the denticulate ligaments and the filum terminale, a ligament that connects the conus medullaris to the first coccygeal vertebrae.<\/p>\n

When the mobility of the spinal cord within the bony spinal canal is limited by the presence of an externally visible spina bifida that produces a tethering, the clinical picture is defined as Tethered cord syndrome with spina bifida<\/strong> or \u201cTethered Cord Syndrome<\/strong>\u201d.<\/p>\n

A spina bifida <\/strong>is defined as a neuro-spinal malformation that is characterized by the incomplete development of the spinal cord and manifests externally and\/or internally, predominantly in the lumbar region. It is classified as a defect of the neural tube, which is the embryonic structure that ultimately becomes the baby\u2019s brain and spinal cord and the tissues that enclose them.<\/p>\n

In spina bifida with meningocele<\/strong>, the meninges \u2013 membranes that surround the spinal cord \u2013 protrude through the opening of the vertebrae and form a fluid-filled sac (Fig.1<\/em>).<\/p>\n

In \u201copen\u201d spina bifida with myelomeningocele,<\/strong> the spinal canal is open along several vertebrae in the lower or middle back (Fig.1<\/em>). At birth, the membranes and spinal nerves protrude through this opening and form a sac on the baby\u2019s back, usually exposing tissues and nerves and putting the baby\u2019s life at risk.<\/p>\n

In the tethered cord syndrome with spina bifida, the spinal cord is anchored by the malformation, producing mechanical injuries due to the traction applied to the whole nervous system, the cranium and vertebral column, associated with specific conditions like Arnold-Chiari syndrome type II, secondary scoliosis and syringomyelia.<\/p>\n

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\nFig.1<\/div>\n

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Diagnosis<\/strong><\/h2>\n

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The diagnosis of tethered cord with spina bifida can be made prenatally. During pregnancy, prenatal testing is done to detect possible birth defects. For spina bifida detection, it includes:<\/p>\n

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