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Child's Nervous System
Published in: Child's Nervous System 9/2013

01-09-2013 | Special Annual Issue

Occult tethered cord syndrome: a review

Authors: Albert Tu, Paul Steinbok

Published in: Child's Nervous System | Issue 9/2013

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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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Metadata
Title
Occult tethered cord syndrome: a review
Authors
Albert Tu
Paul Steinbok
Publication date
01-09-2013
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 9/2013
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-013-2129-1

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