What term describes adhesions that anchor the spinal cord at the back lesion and limit its upward movement during growth?

• A. Tethered spinal cord
• B. Spinal stenosis
• C. Conus medullaris detachment
• D. Arnold-Chiari malformation

Answer: (A)

Adhesions that anchor the spinal cord at the site of a back lesion and prevent its upward movement as a child grows are described as a tethered spinal cord. In conditions like spina bifida with a repaired or intact myelomeningocele, scar tissue or lipoma can fix the cord to the posterior elements or the lesion itself. As growth proceeds, the fixed cord is stretched, leading to progressive neurologic decline such as worsening leg weakness, changes in gait, scoliosis, back or leg pain, and fading bladder or bowel control. Spinal stenosis involves narrowing of the spinal canal and compression from structural changes, not tethering to a lesion. Arnold-Chiari malformation refers to downward displacement of the brainstem structures into the foramen magnum, which can occur with myelomeningocele but is a different mechanism. Conus medullaris detachment isn’t the mechanism described here. The tethered spinal cord concept best fits the described adhesions and growth-related limitation.