Our Summary

Tethered cord syndrome (TCS) is a condition where the spinal cord is under too much tension, causing various symptoms like back pain, bladder issues, constipation, and scoliosis. One less-known symptom of TCS is pain or sensitivity in the perineal region (which is the area between the anus and the genitals). The researchers looked at cases where spinal cord was untethered to understand those who had perineal pain or sensitivity.

They looked at 491 patients who had their spinal cords untethered. Only seven of these patients (1.4%) had perineal pain or sensitivity before the operation. However, all seven patients experienced complete relief from this pain or sensitivity after the procedure. Moreover, five out of these seven patients (71%) had all their initial symptoms go away.

So, the researchers concluded that perineal pain or sensitivity can be a significant symptom of TCS. Untethering the spinal cord can be a good solution for this, providing relief from the pain or sensitivity in the perineal region.

FAQs

  1. What is Tethered Cord Syndrome (TCS) and what are its symptoms?
  2. How effective is detethering surgery in treating perineal pain or sensitivity caused by TCS?
  3. What percentage of patients experienced complete relief from all their initial symptoms post detethering surgery?

Doctor’s Tip

One helpful tip a doctor might give a patient about detethering surgery is to be aware of the potential benefits it can offer in relieving symptoms such as perineal pain or sensitivity. It is important to discuss all symptoms and concerns with your healthcare provider to determine if detethering surgery is the appropriate treatment option for you. Additionally, following post-operative care instructions and attending follow-up appointments are crucial for a successful recovery.

Suitable For

Patients who are experiencing symptoms of TCS such as back pain, bladder issues, constipation, scoliosis, and perineal pain or sensitivity may be recommended detethering surgery. Additionally, patients who have not found relief from conservative treatments or whose symptoms are impacting their quality of life may also be candidates for detethering surgery. It is important for patients to consult with a neurosurgeon or spinal specialist to determine if detethering surgery is the right treatment option for their specific case.

Timeline

Timeline before and after detethering surgery:

Before surgery:

  • Patient may experience symptoms such as back pain, bladder issues, constipation, scoliosis, and perineal pain or sensitivity.
  • Patient may undergo diagnostic tests such as MRI to confirm the diagnosis of tethered cord syndrome.
  • Patient may consult with a neurosurgeon to discuss the option of detethering surgery.

After surgery:

  • Patient undergoes detethering surgery to release the tension on the spinal cord.
  • Patient may experience some pain and discomfort initially post-surgery.
  • Patient gradually experiences relief from symptoms such as perineal pain or sensitivity, back pain, bladder issues, constipation, and scoliosis.
  • Patient undergoes follow-up appointments with the neurosurgeon to monitor recovery and address any concerns.
  • Patient may need physical therapy or rehabilitation to regain strength and mobility in the affected areas.

What to Ask Your Doctor

Some questions a patient should ask their doctor about detethering surgery for perineal pain or sensitivity related to TCS may include:

  1. What is the success rate of detethering surgery in relieving perineal pain or sensitivity in TCS patients?
  2. What are the potential risks and complications associated with detethering surgery for perineal pain or sensitivity?
  3. How long is the recovery period after detethering surgery for perineal pain or sensitivity?
  4. Will I need physical therapy or rehabilitation after detethering surgery for perineal pain or sensitivity?
  5. Are there any alternative treatments or therapies available for perineal pain or sensitivity related to TCS?
  6. How long do the effects of detethering surgery for perineal pain or sensitivity typically last?
  7. Will I need follow-up appointments or monitoring after detethering surgery for perineal pain or sensitivity?
  8. What can I expect in terms of pain management after detethering surgery for perineal pain or sensitivity?
  9. How soon after detethering surgery can I expect to see improvement in my perineal pain or sensitivity symptoms?
  10. Are there any lifestyle changes or precautions I should take after detethering surgery for perineal pain or sensitivity in TCS?

Reference

Authors: Robbins JW, Lundy PA, Gard AP, Puccioni MJ. Journal: Childs Nerv Syst. 2015 Nov;31(11):2141-4. doi: 10.1007/s00381-015-2879-z. Epub 2015 Aug 18. PMID: 26280630