Adult tethered cord syndrome

Although often overlooked, the diagnosis of adult "tethered cord syndrome" (TCS) is important because the manifestations of this syndrome are readily reversible by untethering. Too often, adult patients with TCS are misdiagnosed as having "failed back syndrome" or other unrelated spinal problems. As a result, many patients are treated with modalities which fail to improve neurological function. The aims of this review are to acquaint readers with the pathophysiology, symptomatology, diagnosis, and treatment of adult TCS based on author's experience in 70 cases. Adult TCS manifested by severe back and leg pain, a subtle onset of motor/sensory changes and musculoskeletal deformities is correlated to TCS pathophysiology and imaging studies. Timely diagnosis of TCS can lead to pain relief and restoration of neurologic function and patient gratification.