Tethered spinal cord?
7yr old with spina bifida occulta and scoliosis.. she has tethered spinal cord and has all the symptoms which, as time goes by, they progress. Has anyone had this and have you ever had corrective surgery to detether the spinal cord? She also has a bleeding disorder call Von Wille Brand so the thought of surgery makes me even more uneasy.. I guess I am hoping to hear about a personal experience.
Answers:
Tethered spinal cords are a group of complicated developmental malformations of the spinal cord. These are benign conditions but as with the spina bifida children, can cause terrible consequences if not treated. There is some overlapping of the naming of these conditions and some of them are cases of closed spina bifida. The various forms include such conditions as: tight filum terminale, lipomeningomyelocele, split cord malformations, dermal sinus tracts , dermoids, and cystoceles.
Von Willebrand disease is caused by a deficiency of von Willebrand factor. Von Willebrand factor helps platelets to clump together and stick to the blood vessel wall, which is necessary for normal blood clotting.
VonWillebrand disease affects both men and women. Most cases are mild. Bleeding may occur after surgery or when you have a tooth pulled. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) can make this condition worse. Bleeding may decrease during pregnancy.
This can happen in children who have spina bifida usually with myelomenigiocele or menigiocele. The menigenes get "stuck" to the spinal cord and it begins to pull on the spinal cord and menigenes. Some symptoms of this include progression of paralysis, loss of bowel and bladder control (if it wasn't lost already). I've yet to hear of this in spina bifida occulta, but I had always wondered...I have a very mild occulta myself.
The big risk of a tether is that it can cause chiare malformation where the tension on the cord actually causes the cerebellar tonsils on the brain to herniate out the foraemen magnum (the hole in the base of the skull). In mild cases, this simply results in headaches. In severe cases, this can cause disruption of the flow of the cerebral spinal fluid and cause problems with coordination and balance. These severe cases usually require surgery to either release the tether, and in some cases a craniotomy to relieve pressure off the brain.
If you have a children's hospital near you, they may run a spina bifida clinic where they monitor children with S.B. for changes in weakness and when these are found, they are brought to the attention of the neurosurgeon who helps to evaluate if surgery is necessary. If you are in the Chicago area, Dr. David McClone of Children's Memorial Hospital was the pediatric neurosurgeon with the spina bifida clinic when I did a rotation there several years ago. I'd recommend looking him up.
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Answers:
Tethered spinal cords are a group of complicated developmental malformations of the spinal cord. These are benign conditions but as with the spina bifida children, can cause terrible consequences if not treated. There is some overlapping of the naming of these conditions and some of them are cases of closed spina bifida. The various forms include such conditions as: tight filum terminale, lipomeningomyelocele, split cord malformations, dermal sinus tracts , dermoids, and cystoceles.
Von Willebrand disease is caused by a deficiency of von Willebrand factor. Von Willebrand factor helps platelets to clump together and stick to the blood vessel wall, which is necessary for normal blood clotting.
VonWillebrand disease affects both men and women. Most cases are mild. Bleeding may occur after surgery or when you have a tooth pulled. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) can make this condition worse. Bleeding may decrease during pregnancy.
This can happen in children who have spina bifida usually with myelomenigiocele or menigiocele. The menigenes get "stuck" to the spinal cord and it begins to pull on the spinal cord and menigenes. Some symptoms of this include progression of paralysis, loss of bowel and bladder control (if it wasn't lost already). I've yet to hear of this in spina bifida occulta, but I had always wondered...I have a very mild occulta myself.
The big risk of a tether is that it can cause chiare malformation where the tension on the cord actually causes the cerebellar tonsils on the brain to herniate out the foraemen magnum (the hole in the base of the skull). In mild cases, this simply results in headaches. In severe cases, this can cause disruption of the flow of the cerebral spinal fluid and cause problems with coordination and balance. These severe cases usually require surgery to either release the tether, and in some cases a craniotomy to relieve pressure off the brain.
If you have a children's hospital near you, they may run a spina bifida clinic where they monitor children with S.B. for changes in weakness and when these are found, they are brought to the attention of the neurosurgeon who helps to evaluate if surgery is necessary. If you are in the Chicago area, Dr. David McClone of Children's Memorial Hospital was the pediatric neurosurgeon with the spina bifida clinic when I did a rotation there several years ago. I'd recommend looking him up.
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