Normally the spinal cord slides or moves upward during growth. In children with spina bifida, the spinal cord tends to get stuck in scar tissue or bony deformities at the site of the lesion and cannot slide. This leads to stretching of the cord and its blood vessels which may produce damage to the cord, further interfering with nerve function. Tethering most commonly becomes apparent between the ages of 6 and 12 years (a period of rapid growth). In some cases the symptoms may come on quite suddenly and are fairly easy to recognize. However, symptoms can also arise slowly and by the time they are recognized some damage may already have been done. Common Symptoms:

​

• Bladder changes - increase in urinary wetness, increase in urinary infections, problems noted on x-rays or urodynamics.

• Bowel changes - increase in bowel soiling, change in stool consistency.

• Back pain - especially in the lower back.

• Leg and foot changes - increase in tightness of muscles, decrease in the range of movement or existing function, worsening of ankle and foot deformities, changes in walking.

• Scoliosis - increasing curvature of the spine.

​

Surgery may be required to release (detether) the spinal cord. This procedure will prevent the symptoms from getting worse, but may not improve the present symptoms.

​