Skip to main content

Tethered Cord Syndrome

  • Chapter
  • First Online:
Consults in Obstetric Anesthesiology

Abstract

Tethered cord syndrome (TCS) is a stretch-induced functional disorder of the lumbosacral spinal cord caused by excessive tension between the ligaments and an inelastic structure anchoring caudal end. Its presentations vary according to different ages and underlying pathologic conditions. Changes in the lumbosacral ligamentous laxity with pregnancy as well as the prolonged lithotomy position in childbirth can cause stretching of the conus medullaris. Lumbosacral imaging should be obtained for all patients such as MRI. Neuraxial techniques can be used in selected parturients with TCS.

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

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 219.99
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

Institutional subscriptions

Similar content being viewed by others

References

  1. Michelson DJ, Ashwal S. Tethered cord syndrome in childhood: diagnostic features and relationship to congenital anomalies. Neurol Res. 2004;26(7):745–53.

    Article  Google Scholar 

  2. Yamada S, et al. Pathophysiology of tethered cord syndrome and other complex factors. Neurol Res. 2004;26(7):722–6.

    Article  Google Scholar 

  3. Hertzler DA 2nd, et al. Tethered cord syndrome: a review of the literature from embryology to adult presentation. Neurosurg Focus. 2010;29(1):E1.

    Article  Google Scholar 

  4. Jackson AB, Mott PK. Reproductive health care for women with spina bifida. Sci World J. 2007;7:1875–83.

    Article  Google Scholar 

  5. Tu A, Steinbok P. Occult tethered cord syndrome: a review. Childs Nerv Syst. 2013;29(9):1635–40.

    Article  Google Scholar 

  6. Chowdhury T, Chowdhury M, Schaller B, Cappellani RB, Daya J. Perioperative considerations for neurosurgical procedures in the gravid patient: continuing professional development. Can J Anaesth. 2013;60(11):1139–55.

    Article  Google Scholar 

  7. Lew SM, Kothbauer KF. Tethered cord syndrome: an updated review. Pediatr Neurosurg. 2007;43(3):236–48.

    Article  Google Scholar 

  8. Murphy CJ, et al. Spinal dysraphisms in the parturient: implications for perioperative anaesthetic care and labour analgesia. Int J Obstet Anesth. 2015;24(3):252–63.

    Article  CAS  Google Scholar 

  9. Roberts ND, May AE. Regional anesthesia and spina bifida. Int J Obstet Anesth. 2002;11:12.

    Article  Google Scholar 

  10. Palanisamy A, Klickovich RJ, Ramsay M, Ouyang DW, Tsen LC. Intravenous dexmedetomidine as an adjunct for labor analgesia and cesarean delivery anesthesia in a parturient with a tethered spinal cord. Int J Obstet Anesth. 2009;18:258–61.

    Article  CAS  Google Scholar 

  11. Liu JJ, Guan Z, Gao Z, Xiang L, Zhao F, Huang SL. Complications after spinal anesthesia in adult tethered cord syndrome. Medicine. 2016;95(29):e4289.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jie Zhou M.D., M.S., M.B.A .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Liang, M., Zhou, J. (2018). Tethered Cord Syndrome. In: Mankowitz, S. (eds) Consults in Obstetric Anesthesiology. Springer, Cham. https://doi.org/10.1007/978-3-319-59680-8_156

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-59680-8_156

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-59679-2

  • Online ISBN: 978-3-319-59680-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics