Скачать или смотреть Tethered Cord Syndrome in Children | Dr Naresh Biyani

Tethered Cord Syndrome is a complex congenital spinal condition where the spinal cord is abnormally attached or pulled downward from its typical position, usually near the L1–L2 vertebrae. In this video, Dr Naresh Biyani, Senior Consultant in Pediatric Neurosurgery, offers a comprehensive explanation of this condition, its early signs, diagnostic steps, and surgical management.

What is Tethered Cord Syndrome?
In children with tethered cord syndrome, the spinal cord is stretched due to abnormal attachments within the spinal canal. This restricts the natural movement of the spinal cord and can cause progressive damage if not treated in time.

Key indicators in infants may include:

A patch of hair or swelling on the lower back

Presence of a dermal sinus

Lipoma near the spine

An open area with fluid leakage (neural tube defect)

Asymmetrical gluteal cleft

Skin discoloration or deep dimples on the back

These cutaneous stigmata serve as important early markers for doctors and pediatricians to suspect the condition.

Why Early Detection Matters:
If left untreated, tethered cord syndrome can lead to serious neurological complications as the child grows, including:

Lower limb weakness

Neurogenic bladder (difficulty controlling urine)

Neurogenic bowel (involuntary stool leakage)

Gait abnormalities and orthopedic issues

How is it Diagnosed?
Dr Naresh Biyani emphasizes the role of MRI of the lumbosacral spine, which is the key imaging tool used to confirm:

The low-lying position of the spinal cord

Associated anomalies such as spinal lipomas, dermal sinuses, or bony bars

Other forms of spinal dysraphism

Surgical Intervention and Timing:
Surgery is often recommended at around six months of age for infants diagnosed with this condition. The goal is to untether the spinal cord, relieving the tension and preventing further nerve damage.

The procedure is performed using:

High-precision microscopes

Neuro-electrophysiological monitoring to protect neural pathways during surgery

Multidisciplinary Care Approach:
Children with tethered cord syndrome often need ongoing support beyond surgery. Care involves:

Bladder and bowel management for neurogenic symptoms

Physiotherapy for motor development

Orthopedic evaluations for spine and limb alignment issues

Dr Biyani discusses the importance of collaborative care for improved long-term outcomes, ensuring the child’s mobility, continence, and quality of life are preserved.

This video is essential viewing for parents, pediatricians, and healthcare providers to understand this treatable but often underdiagnosed condition.

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