Spinal cord detethering

Spinal cord detethering is a surgical procedure to treat or ‘release’ a tethered spinal cord, a common condition in children with spina bifida.

A normal spinal cord hangs and moves freely up and down with growth, bending and stretching within the spinal canal. A tethered spinal cord is attached to the inside of the spinal canal and cannot move as freely. This can sometimes cause problems as a child grows and the spinal cord is stretched too much, causing loss of function, like the ability to walk or control the bladder, and in some cases, pain.

What to expect

During surgery

The procedure is performed under a general anaesthetic.

A surgeon will make a small incision in the lower back. A small portion of the bony vertebrae (spine) may need to be removed to allow better access to the spinal cord.

The spinal cord is gently dissected (cut) away from the area of the spinal canal it is attached to and the incision is closed - usually with sutures and covered with a dressing.

Risks

The risks of spinal cord detethering surgery are low, but can include:

• Infection
• Bleeding
• Damage to the spinal cord - this could result in worsening muscle, bladder, bowel and sexual function.
• Cerebrospinal fluid (CSF) leak.

After surgery

Your child will need to lie flat for 24 to 48 hours (but can move from side to side and onto tummy) while they recover in hospital, unless advised otherwise by the surgeon.

Your child may have a tube placed in their bladder to drain urine while they need to remain flat.

Nurses will assist with your child toileting needs, pain relief, pressure area care and closely observe your child’s recovery from the procedure.

The wound will be monitored closely and must be kept clean and dry.

Most children will be in hospital for 5-7 days after their surgery.

Care at home

• Keep the wound clean and dry.
• Change dressings as advised by the hospital.
• Have the wound checked by your GP two weeks after discharge from the hospital.
• Your child should not participate in any high-impact activities and swimming while recovering from the surgery. They should be able to return to their normal activities six weeks after the surgery.
• A follow-up appointment will be arranged approximately six weeks after the surgery.

When to seek help

Call the hospital urgently if there is any leaking from or signs of infection in the surgical wound.

Developed by the Neurosurgery department, Queensland Children's Hospital.  Resource ID: FS336 Reviewed: January 2024

Disclaimer: This information has been produced by healthcare professionals as a guideline only and is intended to support, not replace, discussion with your child’s doctor or healthcare professionals. Information is updated regularly, so please check you are referring to the most recent version. Seek medical advice, as appropriate, for concerns regarding your child’s health.