The tethered spinal cord: an overview.
The growing child with a tethered spinal cord experiences serious neurological deficits as a result of traction on the conus medullaris. Children with tethered cords most commonly present with pain in the lower back, with motor or sensory loss in the lower limbs, with bowel or bladder dysfunction, or with scoliosis. Often, the neurological basis of these symptoms is overlooked. Surgical release of tethering arrests neurological deterioration. Without surgical intervention symptoms will progressively worsen and may become irreversible. Preoperatively the nurse must prepare the child and his family for neurological investigations and for surgery. Postoperatively the nurse must be skilled in assessing spinal cord function, providing pain management, and assisting in ambulation. This presentation will review the pathophysiology of the tethered spinal cord, the preparation of the school-aged child for surgery, and the postoperative nursing care of the pediatric laminectomy patient.
Patterson
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D002648:Child; D006801:Humans; D010371:Pediatric Nursing; D011182:Postoperative Care; D011300:Preoperative Care; D013116:Spinal Cord / Q000002:abnormalities* / Q000601:surgery