Congenital spinal malformations are structural abnormalities of the spine and spinal cord that are present at birth. These conditions occur due to improper development of the spinal column during fetal growth. Some abnormalities are visible externally, while others may remain hidden and only become noticeable as the child grows.
Tethered cord syndrome is a neurological condition in which the spinal cord is abnormally attached to surrounding tissues, causing it to stretch as the child grows. This stretching can lead to nerve damage over time.
It may be associated with:
Myelomeningocele (protrusion of the spinal cord through the back)
Lipomyelomeningocele (abnormal fat attached to the spinal cord)
Tight filum terminale
Other spinal developmental abnormalities
Diagnosis begins with a detailed clinical examination by a neurosurgeon to identify spinal abnormalities or skin markers.
Imaging studies may include:
X-rays / CT Scan – To evaluate the spinal bones
MRI (Magnetic Resonance Imaging) – To assess the spinal cord, nerves, and soft tissues
Urological Evaluation – To assess bladder function, especially in cases of tethered cord syndrome
Surgery is often required to prevent progression and protect nerve function. Surgical options may include:
✔ Shortening the spine to reduce tension on the spinal cord
✔ Releasing the tethered cord by removing scar tissue, fat, or tight filum terminale
✔ Repairing protruding spinal cord defects
✔ Removal of abnormal swelling on the back for functional and cosmetic improvement
Many children experience significant improvement after timely surgical intervention and may regain lost functions.
