Pathophysiology of Tethered Cord Syndrome

Lateral tethering intraspinal lipoma with scoliosis

“…Also glucose consumption of the stretched spinal cord was found to have an essential role in the pathophysiology of the TCS. With traction, decreased glucose consumption, indicated by impaired 2-deoxyglucose metabolism, was consistent with cytochrome reduction, which correlated with the degree of the reversibility of neurological dysfunction and glucose metabolism is altered in parallel to the redox alterations in cytochrome a,a3 [28].…”

Tethered Cord Syndrome Associated with a Thickened Filum Terminale in a Dog

“…TCS therefore typically results in progressive dysfunction of the lumbosacral spinal cord segments 1, 2. The degree and reversibility of this dysfunction depends on both the magnitude and duration of the excessive traction 13. In the case reported here, reaching a diagnosis of TCS proved to be very challenging.…”

Tethered cord syndrome

“…Pathophysiology of TCS of tethered spinal cord 17 has been explained by impairment of oxidative metabolism and electrical activities in the lumbosacral cord segments by the effects of their stretching between the attachments of the lowest pair of dentate ligaments and caudal fixation. The primary lesion that causes spinal cord dysfunction is located in the gray matter of the tethered spinal cord and the long tracts are not involved.…”

“…The future of research in TCS may involve redox studies of cytochrome oxidase in vivo by reflectance spectrophotometry in humans 17 , and somatosensory evoked potential recordings to find impairment of secondary neuron-related conduction 18 (because posterior column conduction is rarely involved). Widely distributed institutional studies will broaden the scientific approach to evaluate each patient and accumulate the data for TCS.…”

“…Blood flow studies are valuable to determine stretching effects on the low-grade and medium-grade traction in animal models, but not for high-grade traction 17 . Similarly, flow studies are likely to be helpful for TCS patients with only mild symptomatology.…”