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Tethered Cord Syndrome

  • Cynthia M. Johnson, MA
Publication Type:


Tethered Cord Syndrome

(Tethered Spinal Cord Syndrome; TCS)


Tethered cord syndrome (TCS) is an abnormal attachment of the spine to the tissue around it. This makes it hard for the spine to move freely. It also leads to strain and stretching on the spinal cord. This can damage nerves and cause pain. Early treatment can improve outcomes.


TCS may be present at birth. This form is caused by a problem with the way the spine forms during pregnancy. A baby may also have other birth defects, such as spina bifida.

TCS that develops after birth may be caused by:

  • Scar tissue following surgery
  • Infection
  • Trauma to the spinal cord
  • A tumor

Risk Factors

TCS is usually diagnosed in childhood, but it may not be found until problems occur when a person is an adult.

The risk of this problem may be higher in adults with:

Spinal Stenosis.

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TCS symptoms vary with age, but most often appear in young children. Some may never have symptoms. Rarely, a person may not have symptoms until they are an adult.

Problems may be:

  • Moles, hair growth, a dimple, or a lump over the lower back
  • Back pain
  • Pain in the legs or groin
  • Numbness and weakness in the legs
  • Changes in the way the legs and feet look
  • Difficulty walking or running
  • Problems controlling urine or stool


The doctor will ask about symptoms and health history. A physical exam will be done. It will focus on the back.

Pictures of the spine will be taken. This can be done with an MRI scan .


The goal of treatment is surgery to release the tethered cord. The type of surgery done will depend on what is causing TCS.

People who do not have surgery will be monitored for any changes. Symptoms can be managed with:

  • Medicines, such as:
    • Pain relievers
    • Muscle relaxants
  • Physical therapy to promote strength, flexibility, and range of motion


Folic acid supplements and proper prenatal care lower the risk of this problem during pregnancy.





  • Tethered spinal cord. Boston Children’s Hospital website. Available at: https://www.childrenshospital.org/conditions/tethered-spinal-cord.
  • Tethered cord syndrome. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/tethered-cord-syndrome.
  • Tethered spinal cord syndrome. American Association of Neurological Surgeons website. Available at: https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Tethered-Spinal-Cord-Syndrome.


  • Laura Lei-Rivera, PT, DPT
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.