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6 year old having tethered spinal cord. Lock of hair on the back and limp. Surgery advised. Will there be any problem with brain functioning after surgery?

MY daughter- 6 yrs old had been diagonised of a tethered spinal cord . Symptoms - Lock of hair on her back, a slight limp. we are advised a detethering surgery to avid/ptrevent any complications in future. Wanted to know whether the current surgery is likely to 1) cause temperory/ permanent loss of motor/sensory functions 2) cause any adverse effect in brain functioning/ inteligence 3) cause a loss/alterations in bladder/bowel/ sexual functions Please advise
Asked On : Thu, 2 Aug 2012
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Pediatrician, Surgery 's  Response
Thank you for your query
Firstly you have to understand what a tethered cord syndrome is. Normally our spinal cord lies inside our back bone. It controls the regional movement and bladder, bowel and sexual functions. It lies free inside the backbone. However sometimes it may be stuck or tethered to the back bone. Initially its not a problem. But later as the child grows, the backbone grows in length but the spinal cord does not increase in length. If it were free it wont matter but but since it is stuck, it exerts a relative pull on the spinal cord. This causes all functional damage. The limp is due to that. The tuft of hair is just an external indicator of the problem within. Now the goal of the surgery is primarily to avoid further stretch. The damage that has already occurred can't be reversed or very slight improvement may be seen. But if you leave it tethered it will cause worsening as the child's height will increase. Worsening is in form of decreased movement of the legs or some form of loss of control over bladder or bowel. The first aim is to arrest damage, possible by-effect may be minor improvement. But every surgery has some risk. In experienced hands most children don't have a problem. But complication can occur in 1 % cases and some worsening may be seen. But look at it this way. If you get operated the risk of worsening is 1%. But if you don't get operated the risk of worsening is 99%. So i would recommend you get the detethering surgery done. Hopefully everything will be fine and your child will improve.
Hope that helps
God bless you
Answered: Sat, 9 Feb 2013
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