Tethered spinal cord can cause what primary issue in neural tissue metabolism?

• A. Metabolic changes and ischemia
• B. Hypermetabolism and regeneration
• C. Hyperplasia and aneurysm
• D. Enhanced myelin repair

Answer: (A)

Chronic tethering of the spinal cord causes ongoing traction on the cord and its blood vessels, which impairs spinal cord perfusion. This reduces oxygen and nutrient delivery to neural tissue and can lead to venous congestion, creating a state of ischemia and hypoxia. When neurons and glia lose adequate blood supply, their metabolism shifts toward less efficient, anaerobic pathways, energy failures occur, and harmful metabolites build up. Over time, this metabolic stress injures neural tissue and underlies the progressive neurologic deficits seen with tethered cord. This metabolic-ischemic pattern is the primary issue, whereas options implying increased metabolism, growth, or reparative processes do not reflect the core problem in this condition.