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spinal cord tethering syndrome is a common spinal cord deformity in clinical practice ，it belongs to congenital development (fā)deformity ，can be found (fā)born at any age. the spinal cord of normal humans is located in lumbar spine 1 、2above the gap, if this limit is exceeded ，the spinal cord enters the lower lumbar spinal canal ，called the status of spinal cord duct (t toi)。formation of spinal cord duct status (t toi)there are many causes ，such as lipoma 、bone quality (zh the)anomalies, etc., can lead to changes in the spinal cord position ，causes spinal cord duct 。if the spinal cord is tethered (chǎn)nerve (jīng)system (tǒng)the symptoms of spinal cord ductal system 。

spinal cord duct syndrome, can be detected (fā)born in any age 。in clinical practice, it is common (fā)the sick period is the baby period 、teenager (fā)cultivation period 、middle-aged and elderly. congenital spinal cord tethering status (t toi)patient ，can be developed in the above three periods (fā)sick 。baby period (fā)sick person ，performance (xi ton)for urinary and defecation disorders, lower limb development (fā)educating abnormalities ，or as age increases ，neuros (jīng)skeletal prostate (fā)education gradually emerges (xi ton)missing ，spinal cord nerve (jīng)in the original pathological state (t toi)being pulled down gradually ，especially (fā)appears during the nurturing period (xi ton)growth peak ，finally leading to disease (fā)do 。some patients develop in middle-aged and elderly people (fā)sick ，because of the nerves (jīng)fast aging speed.

comprehensive signs of spinal cord tethering ，due to spinal cord nerve (jīng)being stretched, can be produced (chǎn)feeling 、extraordinary exercise and abscess muscle function ，the specific situations are as follows:

1、sensory function abnormal: below the penile plane of the spinal cord ，the feeling of the following limbs, elbows, etc. is missing;

2、anomalous motion function: (chǎn)the end of life sports (ji and)structure (g oru)appear (xi ton)anomaly, such as muscle growth (fā)infertility 、powerless, express (xi ton)different lower limbs are thick ，influence walking, etc.;

3、anomalous function of the ablation muscle: including the urethral ablation muscle 、anal sprocket, manifestation (xi ton)for incontinence 、constipation, urinary retention 。

patients with spinal cord tethering syndrome need to undergo four aspects of examination:

、it's about the spinal cord status (t toi)checking, usually it is to be taken X take a light sheet to see how the bones in the lumbar spine are long;

second 、to do magnetic resonance, check the tethering status of the spinal cord (t toi);

third, a very important thing is to do urinary exercise ，how to check the bladder;

fourth, general physical inspection ，do necessary inspections on lower limbs and sills 。

comprehensive signs of spinal cord tethering (tethered cord syndrome, TCS)it means that the spinal cord is stretched and sluggish due to congenital or acquired factors. 、causes spinal cord (xi ton)ischemia 、deficiency of oxygen 、neuros (jīng)pathological changes such as organizational change ，appearing in the clinic (xi ton)feelings of lower limbs 、sports dysfunction or deformity 、neurological disorders, etc. (jīng)a trauma group 。TCS can be found in any age (fā)diseases, due to different pathological types and ages, their clinical manifestations (xi ton)different 。how many causes of spinal cord tethering ，such as congenital spinal fissure 、dural (n andi)、external lipoma 、myelocele, lumbosacral surgery (shù)posterior spinal cord adhesion 、causes of spinal cord fissure deformity, etc. 。the part of the spinal cord tethering ，most (shù)is the spinal cord or end of the end ，but 、the thoracic spinal cord was pulled by various factors ，form various nerves (jīng)the trauma of damage is also derived from the symptom of spinal cord tethering 。

the causes of spinal cord tethering syndrome can be divided into primary (fā)sex and continuity (fā)sex 。original (fā)sex TCS causes: in embryonic (fā)in the early stage of nurturing, the spinal cord and spinal canal are as long as the spinal cord, and then the spinal column grows faster than the spinal cord, because the spinal cord's head is (c and)fixed, so the spinal cord moves upwards in the embryo 20 w at the time, the spinal cord is moved upward L3~4vertebral level, 40 w at the time L3 vertebral level ，the end of the spinal cord of the baby born is located at L1-2 level 。three months after birth, the spinal cord rises to adult level, that is, the end of the cervix is ​​located at L1 level. spinal cord circumcision and deformity to the end (adult straight line is less than 2 mm)。during the spinal cord upward movement, if there is a nerve (jīng)incomplete closing 、spinal canal (n andi)lipoma 、spinal cord cyst or teratoma 、causes of spinal cord fissures? qū)еthe pathological changes such as the low position of the round cord will cause poor spinal cord end retraction and the horsetail will eventually become adhered to 、the constriction leads to development (fā)infertility ，called original (fā)comprehensive signs of spinal cord tethering 。continue (fā)sex TCS causes: most of them are lumbosacral spina bifida repair (shù)posterior or spinal dura (n andi)operation (shù)later, the scar tissue at this site is attached to the spinal cord and the tail, and the scar contraction causes the spinal cord to be stretched, which can also be seen on the spider website. (wǎng)adhesions formed after local bleeding in memitis ，called continuous (fā)comprehensive signs of spinal cord tethering 。

according to (jù)typical medical history 、clinical manifestations (xi ton)assisted in the examination, it is not difficult to diagnose the spinal cord tethering syndrome. 。because the disease often has no symptoms or symptoms in the early stages of this disease (fā)discover, a few (shù)patient acute development (fā)sick ，although (jīng)treatment cannot improve nerves (jīng)functional dysfunction. therefore ，improve the understanding of this disease, and achieve early diagnosis and timely treatment. 。for the following clinical manifestations (xi ton)those ，especially children ，be wary of the possibility of this disease: ①hairy skin in the lumbosacral area and abnormal pigmentation 、hemangioma 、pity 、sarcopenia or subcutaneous tract; ②the feet and legs are not in line 、powerless; ③insensitive spina bifida; ④unexplained urinary incontinence or relapse of urinary tract infection. clinical diagnosis of spinal cord tethering system (jù)：①a wide range of pain ，can't use a single nerve (jīng)to explain the damage; ②adults are appearing (xi ton)there is a clear cause of intimacy before the tragedy; ③bladder and straight kidney dysfunction ，by (jīng)often appear (xi ton)urinary tract infection; ④feeling progressive aggravation of movement disorders; ⑤there are different congenital deformities ，there may have been lumbosacral surgery (shù)history; ⑥MRI and (or )CT spinal canal angiography (fā)now (xi ton)the spinal cord is abnormal and (or )final thickening 。

other assisted inspections

1.MRI it is a method to diagnose the comprehensive signs of spinal cord ducts. it can not only (fā)now (xi ton)low spinal cord ，and it can clearly cause the causes of spinal cord duct syndrome 。

2.CT spinal canal imaging CT myelography can show lipoma 、spinal cord round 、matissac (jīng)relationship with the dura mater ，conducting surgery (shù)the approach has a guiding role 。in addition ，CT can show bone deformities 、spinal fissure 、spinal canal (n andi)bone tumors, etc. but CT the sensitivity and reliability of the diagnosis of spinal cord tethering syndrome are not as good as MRI，CT spinal canal symptom is also very confusing (chu tong)sexual examination ，therefore, for patients with typical spinal cord tethering symptoms ，MRI the diagnosis is sufficient 。because MRI and CT each has its own merits (yōu)disadvantages, comprehensive signs of rehabilitation of spinal cord ducts or MRI clinic suspicious person ，need to contact (li ton)co-applied MRI and CT spinal canal imaging 。

3.X linear film due to MRI and CT spinal canal imaging has become the main diagnosis method for this disease ，X linear films and regular (guī)spinal canal imaging is rarely used 。X flat-line film inspection is only used to understand whether there is any spinal side (c and)deformity and erectile dysfunction (shù)anterior vertebrae positioning 。

4.other inspections

(1)neuros (jīng)electrophysiological examination: can be used as a diagnosis of spinal cord tethering syndrome and diagnosis (shù)post-nerve (jīng)a means of function recovery 。Hanson isolate-determined electrophysiological conditions of sacral reflex in patients with spinal cord tethering corpus ，send (fā)now (xi ton)the shortening of the incubation period of the sacral reflex is one of the electrophysiological characteristics of the comprehensive signs of the spinal cord duct. Boor test the continuous (fā)post-love neurology in patients with sexual spinal cord tethering syndrome (jīng)SSEPs，send (fā)now (xi ton)SSEPs reduce or yin, surgery again (shù)after loosening ，post-love nerve (jīng)of SSEPs increase, proves that the final loosening of the disease (shù)post-nerve (jīng)recovery of functions 。

(2)B super: to age <1aged patients suffer from posterior spinal canal (ji and)structure (g oru)not yet fully mature and ossified, B super visible spinal cord ，and can be based on (jù)spinal cord beat condition to judge the disease (shù)will there be tied up later 。

(3)bladder function check: including bladder (n andi)pressure measurement 、bladder lens examination and urethral ablation muscle fibre examination 。patients with spinal cord tethering syndrome may appear (xi ton)across muscle-detrusor common miscomplication (di too)、bladder (n andi)pressure rise (suffering )or lower (low sex )and abnormal changes in the amount of urine remaining in the bladder 。aesthetics (shù)previous, art (shù)bladder function checks are performed separately to help determine surgery (shù)effective 。

clinic diagnosis: spinal cord duct syndrome requires a herniation of the lumbar vertebrae 、pustomy muscle swelling 、myalgia, spinal cord tumor, etc. 。adult density (fā)the patient also needs to be treated with spinal canal narrowing and other 。use CT、MRI scanning can help with clear diagnosis 。