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DrRussMd
DrRussMd, Board Certified MD
Category: Neurology
Satisfied Customers: 65266
Experience:  Internal medicine doctor, diagnose and treat neurology patients, many years
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My daughter had a tethered spinal cord, but had it

Customer Question

My daughter had a tethered spinal cord, but had it surgically de-tethered when she was ten years old. It had been noted through various medical exams that her rectum looked unusually relaxed. We had been told that a tethered spinal cord could lead to bowel problems, but even though she complained of stomach pain since she was old enough to talk, she never really had any issues with her bowel movements. She is now twenty one, and despite a very healthy lifestyle ( very physically fit and an extremely healthy diet with lots of fresh fruits and vegetables), she is experiencing chronic constipation and no longer receives a nerve signal that indicates a need to move her bowels. Is it possible that these symptoms are related to nerve damage caused by her tethered spinal cord?
JA: Do you keep personal medical records to help track this?
Customer: She had a colonoscopy two years ago, and has had several visits with gastroenterologists. One of which was today, but he didn't seem to have much info about tethered spinal cords.
JA: Anything else in your medical history you think the doctor should know?
Customer: She is now experiencing some occasional bowel leakage, but I'm assuming that could be due to her constipation?
Submitted: 1 month ago.
Category: Neurology
Expert:  DrRussMd replied 1 month ago.

Hi.
Welcome to just answer. I am here to answer questions for education and information. I will respond shortly with an answer, or a question for you

Expert:  DrRussMd replied 1 month ago.

Has she seen a neurologist

Has she had an MRI of the lower spine?

recently?

Has she had an EMG/NCS test

Customer: replied 1 month ago.
She had a follow up with her neurosurgeon after her detethering surgery, but hasn't seen one since for any issues regarding her tethered spinal cord. She also has scoliosis and had regular check ups with a pediatric orthopedist ( she has a 36 degree curvature which was congenital due to an extra partial vertebrae, but it hasn't altered her lifestyle or abilities in any way). She hasn't had an EMG/NCS test that I can remember.
Customer: replied 1 month ago.
my question is, is it possible that her current bowel problems (and loss of a nerve signal to indicate that she needs to go) be linked to any damage caused by having a tethered spinal cord? I've read that symptoms of tethering can occur during periods of growth and ten to 20 percent require a repeat surgery. Are her current symptoms typical of someone who has had the de-tethering surgery even if a decade has passed since the surgery?
Expert:  DrRussMd replied 1 month ago.

Possible but unlikely.

The idea that generalized cord compromise would exclusively affect the bowel is not likely at all.

There would be other symptoms.

However, the EMG/NCS would be needed to confirm that this is not the case.

Given her situation she should

a. see a neurologist

b. have an MRI of the lower spine.

c. Have the EMG/NCS.

OK, let me know if you have more questions.

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