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Hidden Symptoms of Traumatic Spinal Cord Syndrome: How to Recognize These Subtle Warning Signs?
Tethered Cord Syndrome (TCS) is a group of neurological diseases associated with spinal cord malformations. Various forms of these disorders include tight filum terminale, lipomyelocele, split cord malformation (bicord), and other occult lesions. All of these conditions involve traction on the spinal cord at the base of the spinal canal, effectively creating a "pulled cord" condition. Under normal circumstances, the spinal cord should hang freely in the spinal canal and be able to move freely during growth, bending and stretching. However, myelopathy means that the spinal cord is fixed at one point and cannot move normally.
"Symptoms of spinal cord traction can differ between children and adults, and this is often complicated by delayed diagnosis."
In children, possible symptoms of myelopathy include lesions in the lower back, hair patches, dimples, hemangiomas or fatty tumors, deformities of the limbs and spine, and leg muscle weakness. As the disease progresses, low back pain, scoliosis, and urine abnormalities may also develop. In adults, symptoms may be more severe and include severe lower back pain, bilateral muscle weakness, urinary dysfunction, and bowel control problems.
"Among adults, more than 70% of patients will experience further symptoms of neurogenic bladder, while among children, only 20% to 30% will experience similar conditions."Hidden symptoms and delayed diagnosis
It is important to note that many symptoms of spinal cord traction may go unnoticed in childhood and are often not diagnosed until adulthood, due to the continued traction on the spinal cord as it grows. This makes early identification crucial, as spinal cord injuries can gradually worsen if left untreated.
Sometimes, scar tissue that forms after a spinal cord injury can block the flow of fluid around the spinal cord, causing cysts to form inside the spinal cord. This condition is called syringomyelia, which can further cause loss of movement or sensation. and symptoms such as pain.
Diagnosis and treatment
For children younger than 8 weeks of age, ultrasound can be used to detect the presence of spinal cord traction, and MRI is considered the gold standard for diagnosing spinal cord traction. Typically, imaging of the "lower end" of the spinal cord, or below the L1-2 disc, will suggest the presence of traction. Treatment includes surgery to relieve the stretch on the spinal cord, and surgery may be necessary if neurological deficits have already occurred.
"For older patients, surgery to remove diseased spinal structures is common, but the benefits and risks of this treatment need to be assessed individually."
Future Research Directions
Although current treatments can improve symptoms, many neurological and motor deficits are irreversible. Spinal cord traction is closely related to a variety of other diseases such as Chiari malformation and Ehlers-Danlos syndrome, and further research is needed to clarify these associations. Early screening and long-term monitoring of patients are also necessary measures to seek better prognosis.
With the deepening of understanding of spinal cord traction, patients' quality of life is expected to be further improved. In this process, the joint efforts of medical professionals, family members and patients are particularly important. Can they work together to find more effective ways to identify and treat spinal cord traction?
