Tethered spinal cord refers to a condition where the bottom of the spinal cord is pulled down and fixed or stuck in a position instead of floating freely. In growing children, a tethered spinal cord can permanently damage the spinal nerves and can result in loss of function.

Tethered spinal cord has many forms and severities. Spina bifida/myelomeningocele is one of the most severe forms and diagnosed when a baby is born. In less severe cases, signs of a tethered spinal cord can go unnoticed and untreated even into adulthood as it can be difficult to diagnose. Often for the less severe types of spina bifida, both imaging (ultrasound or MRI), other testing (urodynamic testing), and symptoms are put together in order to diagnose tethered cord as a syndrome. In these cases, there isn’t one test that diagnoses it definitively.

Common symptoms of a tethered spinal cord in children are leg pain or restless legs, a curved spine (scoliosis), bowel and/or bladder problems, and leg length or feet size differences. Some patients with tethered spinal cord have a dimple in the lower back, thick hair growing over the spine, a lump in the lower back, or other abnormal skin markings. If your child is experiencing any of these symptoms or has any of the physical signs of a tethered spinal cord, please consult with your child’s pediatrician for further evaluation.

UNC pediatric neurosurgery works closely with pediatricians and specialists to diagnose tethered spinal cord and then develop the best treatment plan for each child.

Tethered Spinal Cord Treatment

If left untreated, a tethered spinal cord can cause serious damage to the spinal nerves as a child grows. When treated early on, children with a tethered spinal cord have a normal life expectancy and development.

Intraoperative neuromonitoring is utilized during surgery to closely monitor the nerves and muscles. This allows our neurosurgeons to surgically correct the tethered spinal cord without causing nerve damage.

Our pediatric neurosurgery team performs this surgical procedure with a microscope to release the tethered spinal cord as minimally invasively as possible. Typically, children are able to return to normal activities relatively quickly after their surgery.

In the more severe types of tethered cord, your child will continue to be monitored by their pediatrician and other members of their care team after surgery to make sure that the spinal cord does not become re-tethered later in life. If the spinal cord does become re-tethered, your care team may recommend additional surgery. This does not usually occur in the less severe forms of tethered cord.


We offer weekly pediatric neurosurgery clinics in Chapel Hill, Raleigh, Pinehurst, and Wilmington. Visit our pediatric neurosurgery clinic locations page for the clinic or hospital nearest you or call 919-445-2410 to schedule an appointment.

UNC Neurosurgery also offers spinal neurosurgery for adult patients.