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Occult tethered cord syndrome: a review

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Abstract

Background

Tethered cord syndrome is a well-defined condition, the management of which is fairly uniform. In contrast, occult tethered cord syndrome is a recently defined entity, where the management is still controversial. The pathophysiology is unclear and may be conceptually incongruent with current understanding of typical tethered cord syndrome. Presentation, investigation, and management of this condition are reviewed, and current understanding is presented.

Purpose

The aim of this study is to review the presentation, pathophysiology, investigation, and management of occult tethered cord syndrome.

Methods

Literature review.

Results

Patients with occult tethered cord syndrome presents predominantly with urologic symptoms. Adult and pediatric patients vary slightly in their presentation with a higher incidence of pain in the former and incontinence in the latter. Operative management for these patients is associated with consistent improvement in urologic function in particular, although surgery is also associated with risk of worsening symptoms. The natural history of untreated patients is unknown.

Conclusions

As occult tethered cord syndrome becomes increasingly recognized, it is important to be aware of the potential benefits of operative intervention for appropriately selected patients. Given that the natural history of this entity remains unknown, a clinical trial is currently underway that may assist in defining the role for operative management in treating this condition.

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Disclosure

The authors have no personal financial or institutional interest in any of the drugs, materials, or devices described in this article.

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Authors and Affiliations

  1. Division of Neurosurgery, University of British Columbia, Vancouver, BC, Canada

    Albert Tu & Paul Steinbok

  2. Division of Neurosurgery, Department of Surgery, British Columbia Children’s Hospital, Vancouver, BC, Canada

    Paul Steinbok

  3. Division of Neurosurgery, B.C. Children’s Hospital and UBC, 4480 Oak St., Room K3-159, Vancouver, BC, Canada, V6H 3V4

    Paul Steinbok

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  1. Albert Tu
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Correspondence to Paul Steinbok.

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Tu, A., Steinbok, P. Occult tethered cord syndrome: a review. Childs Nerv Syst 29, 1635–1640 (2013). https://doi.org/10.1007/s00381-013-2129-1

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  • DOI: https://doi.org/10.1007/s00381-013-2129-1

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