The most common treatment for tethered spinal cord is a lumbar laminectomy to release the tethered cord. For this procedure, the patient is placed under general anesthesia. The neurological surgeon makes an incision in the lower back to expose the site where the spinal cord is pinned, then frees it by releasing the stuck portion of the cord. The neurosurgeon may also repair any developmental abnormality during this operation.
The surgery typically takes about four hours, but often takes longer as the neurosurgeon works to remove the adhesion. Surgery may be difficult, and is always accompanied by careful neurophysiological monitoring to minimize damage to nerves.
After surgery, patients need to remain flat for 24 to 36 hours to minimize the risk of a spinal fluid leak. Physical activity is limited for the next several weeks to allow the surgical site to heal, but most surgical patients have excellent outcomes and can quickly resume normal activities.
There is a risk that the spinal cord may become re-tethered at a later time, so ongoing monitoring is necessary.
Tethered cord is a complex disorder that is best treated at a major medical center by a neurosurgeon with expertise in the condition. At Weill Cornell Medicine Pediatric Neurosurgery, it is one of the conditions treated by the specialists at the Chiari CARE program.
Reviewed by Jeffrey Greenfield, Ph.D., M.D.
Last reviewed/last updated: April 2021
