- Open, i.e. which are visible outside on the back of the patient.
- Closed, i.e. which have no signs visible to the naked eye.
It’s a neurological condition that stretches the spinal cord like a rubber band due to abnormal tissue attachments. A number of conditions may cause this like myelomeningocele which is abnormal protrusion of spinal cord in the back, abnormal fat in the spinal cord (lipomyelomeningocele) or other abnormalities.
Symptoms of Congenital Spinal Malformation vary depending on a child’s specific condition but can include:
The child might not exhibit any symptoms initially or few skin marks may be present, but when the child is in growing age any of the following can appear
- Difficulty in sitting, standing & walking
- Breathing problems
- Bathroom issues (accidents, incontinence, constipation, urine retention)
Ankle and other lower limb bony abnormalities
Diagnosis of Congenital Spinal Malformation
- Clinical examination – A neurosurgeon will examine the child to check his or her back and spine to look for the specific signs of misalignment or lesions.
- Imaging tests – different investigations exist to see the internal aspects of spine and spinal cord
- Computed tomography (CT) to create images of the spinal bony column
- Magnetic resonance imaging (MRI) to see the tissues and nerves of the spinal cord
- Urology exam. If your child is diagnosed with tethered spinal cord, the neurosurgeon may recommend a consultation with an urologist to evaluate bladder function.
Treatment for Congenital Spinal Malformation
Treatment focuses on reducing pain, restoring function and correcting harmful abnormalities.
Mainstay of treatment is surgery. There are multiple options for surgically treating children with a tethered spinal cord:
- The spine itself may be shortened to relieve stress on the nerves.
- The nerves themselves may be freed by detaching them from scar tissue, fat or by releasing a tight filum terminale in selected patients.
- Removal of abnormal swelling on the back for cosmesis.
- Many patients see real benefits after surgery and regain lost functions.