![]() Patients of all ages may present with urinary sphincter dysfunction, which may present as urinary tract infections without an alternative cause or episodes of incontinence between scheduled straight catheterizations. ![]() It is hypothesized that in this subset of patients, the degree of tethering is not significant enough alone to cause symptoms, but the added trauma increases the stress on an already tense spinal cord, ultimately leading to neurologic or urologic deterioration. Trauma often leads to symptomatology within this population and may involve major direct trauma to the spine or may be mild from provoking factors such as exercise, pregnancy, childbirth, etc. For the adult patient without a history of spina bifida, the pain remains the predominant presenting symptom, followed by weakness and urologic dysfunction. In the adult patient with a history of spina bifida, the clinical presentation is like that of the adolescent, predominantly with pain and sphincter dysfunction, which can be provoked by flexion and extension movements of the lumbosacral spine. Incontinence and sphincter dysfunction are also common symptoms in this age group. įor patients in late childhood and early teenage years, pain is the predominant presenting symptom, specifically non-dermatomal pain in the lumbosacral region, perineum, and lower extremities. Pain in the back and lower extremities also presents complaints within this age group. Children and toddlers commonly present with sensorimotor dysfunction, with the sensory loss occurring in a non-segmental distribution. The clinical presentation of tethered cord syndrome is broad and varies with underlying etiology and age at presentation. ![]()
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