Re: another curious question...

February 21, 2006

Dear

Please see my website for an explanation of this. It is at

<http://www.btinternet.com/~tetheredcordresources/>

and go to the Tethered cord Syndrome page

If you need more explanation, please email me privately

Regards

Nina

Bristol, UK

--On 21 February 2006 15:54 +0000 amandamariebaker

wrote:

> Hello everyone,

>

> In reading some of your posts, I gather that TCS usually worsens as a

> child grows...the spine lengthens and creates more tension.

> Well, here is what I just don't get: I am 35 years old. My symptoms

> didn't really become bothersome until my mid-20's. My headache became

> constant at age 28. It's been in the last 3 months that I've started

> to notice lower back pain...and worse headaches. I know my bone

> structure hasn't changed. I'm still 5'3 " . So, what's the reason that

> someone in their 30's starts to worsen? I admit, I am diagnosed with

> chiari (I) and perhaps that is a contributing factor. But, also,

> chiari I is an issue with BONE structure. HOW can this progressively

> get worse if your bones have reached a " stop " in development?

>

> Not Medical Advice. We Are Not Doctors.

> Need help with the list? Email

> kathy@...,michelle@..., rick@...

>

February 21, 2006

was found muttering these words:

I'm not really sure, but it certainly was the case for me in my 40's. I

had problems in my childhood and teens, then things were very quiet until

my 40's -- when there were some arthritic changes. I'm sure that started

things rolling.

>>Hello everyone,

>>

>>In reading some of your posts, I gather that TCS usually worsens as a

>>child grows...the spine lengthens and creates more tension.

>>Well, here is what I just don't get: I am 35 years old. My symptoms

>>didn't really become bothersome until my mid-20's. My headache became

>>constant at age 28. It's been in the last 3 months that I've started

>>to notice lower back pain...and worse headaches. I know my bone

>>structure hasn't changed. I'm still 5'3 " . So, what's the reason that

>>someone in their 30's starts to worsen? I admit, I am diagnosed with

>>chiari (I) and perhaps that is a contributing factor. But, also,

>>chiari I is an issue with BONE structure. HOW can this progressively

>>get worse if your bones have reached a " stop " in development?

>>

>>Not Medical Advice. We Are Not Doctors.

>>Need help with the list? Email

kathy@...,michelle@..., rick@...

>>

February 21, 2006

I don't usually answer these, but I could not pass this one up. I am 49

and things are getting worse as I get older, but I do believe that it is

because my body is starting to feel the stress and strain that all of

this has caused for so many years and reacting and/or wearing out.

Getting older is not fun...

Carol Barber

another curious question...

Hello everyone,

In reading some of your posts, I gather that TCS usually worsens as a

child grows...the spine lengthens and creates more tension. Well, here

is what I just don't get: I am 35 years old. My symptoms

didn't really become bothersome until my mid-20's. My headache became

constant at age 28. It's been in the last 3 months that I've started

to notice lower back pain...and worse headaches. I know my bone

structure hasn't changed. I'm still 5'3 " . So, what's the reason that

someone in their 30's starts to worsen? I admit, I am diagnosed with

chiari (I) and perhaps that is a contributing factor. But, also,

chiari I is an issue with BONE structure. HOW can this progressively

get worse if your bones have reached a " stop " in development?

Not Medical Advice. We Are Not Doctors.

Need help with the list? Email

kathy@...,michelle@..., rick@...

February 21, 2006

This is from my website (and the information is from medical journals!),

Nina

Normal spinal cord

The normal spinal cord begins at the junction of the skull with the

cervical (neck) spine, and the cord continues down the spinal column until

the mid-back region, the lumbar area. Beyond this point nerves continue

down the spinal canal (as the cauda equina) and the spinal cord ends with

the non-functioning tissue known as the filum terminale, which usually has

the elasticity similar to a rubber band. The cord and the spinal bones

(vertebrae) initially start out the same length but as the foetus and child

grows, the vertebrae grow faster than the cord and therefore the cord

effectively " ascends " within the spinal column. In people with no tethered

cord the spinal cord ends up hanging freely within the vertebrae, protected

by cerebrospinal fluid and, as there is no obstruction to its movement, it

is able to flex and move freely with everyday activities.

Pathology

Any event which interferes with the development of the spinal cord and

cauda equinae can lead to the ingrowth of other tissues like fat and skin,

which creates an abnormal attachment, or tethering of the spinal cord

Tethering of the spinal cord interferes with the normal regression process

causing damage to the spinal cord as it is stretched and placed under

abnormal tension

The tension injures the spinal cord and may cause symptoms

Tethered spinal cord

The embryonic spinal bones fuse together at different rates in a zip-like

fashion proceeding in both directions. However, the bones at the caudal

(tail) end form by coalescing in a disorganised way, and if the spinal cord

becomes trapped in this area of rapidly amassing material, it becomes

" tethered " . Due to tethering, as the child grows there is no free movement

of the cord and it is not able to ascend the spinal column. The lower part

of the cord is therefore stretched and progressive neurological damage

occurs as more tension is placed on the nerves emanating from the end of

the cord. Blood circulation to the cord and the lower extremities may be

reduced and in most cases the nerve impulses may be weak, distorted or

absent.

Neuronal (nerve) dysfunction due to tethering is subsequent to, firstly,

metabolic derangement or hypoxia (the reduction of oxygen supply to tissues

below physiological levels, despite adequate passage of blood through the

tissue), and, secondly, the electrophysiology of the cord is impaired due

to the distortion of neuronal membranes. Effectively, hypoxia means that

the cord is deprived of oxygen and therefore electrical impulses are

depressed. Physically this causes the nerves to reduce or stop sending

impulses, both for sensory and motor functions, thereby creating and

exacerbating progressive neurological deterioration.

At birth, there may be few external signs that the cord is tethered and as

the spinal cord and its tissues are generally not fully exposed, there is

rarely cause to operate immediately, except perhaps in the case of

connecting dermal sinus tracts (skin-to-cord). A lipomyelomeningocele is

most obviously visible as a skin-covered fatty mass in the lumbosacral

region.

It used to be thought that most of the nerve stretching occurs at a time of

rapid growth at puberty, but foot deformities and scoliosis can be apparent

by the age of two as the cord stretching has effectively been going on

since ~ 6 weeks post-conception. Once damaged, neurological function may

not necessarily be recovered or improved. As indicated in the sections on

spinal dysraphism, both children and adults can experience worsening

symptoms of tethered spinal cords. In children the deterioration is caused

by stretching of the cord with natural childhood growth. However in adults

" without appropriate intervention most deteriorations in tethered cords are

gradual, insidious over years. Rarely it can be very sudden, as can occur

if one is put in the lithotomy position. Irreversability also occurs slowly

and insidiously " . [ian Pople, 2002]. Also see this article by Shokei

Yamada, which is very informative: " Pathophysiology of Tethered Cord

Syndrome: Correlation with Symptomatology " , Neurosurgical Focus, 16(2),

2004, Article 6

Adults with prior stable symptoms of a tethered cord can experience

worsening of their symptoms due to general physical wear and tear on the

cord and spinal nerves, and subsequent hypoxia and ischaemia of the spinal

cord. These symptoms may be increased pain, decreased function, mobility

and sensation, and further deformation of already poor feet. They may be

fully accustomed to their condition, but any new symptoms that are out of

the ordinary should be investigated by neurosurgical consultants who have a

special interest in the area of spina bifida and spinal cord tethering.

Surgery may be recommended in order to arrest further neurological damage

and the deterioration of the function and sensation of the limbs, bladder

and bowel.

--On 21 February 2006 11:11 -0500 Carol Barber

wrote:

> I don't usually answer these, but I could not pass this one up. I am 49

> and things are getting worse as I get older, but I do believe that it is

> because my body is starting to feel the stress and strain that all of

> this has caused for so many years and reacting and/or wearing out.

>

> Getting older is not fun...

>

> Carol Barber

>

> another curious question...

>

> Hello everyone,

>

> In reading some of your posts, I gather that TCS usually worsens as a

> child grows...the spine lengthens and creates more tension. Well, here

> is what I just don't get: I am 35 years old. My symptoms