Glossary term:

Tethered cord

During development, inside the womb, the skeletal parts of the spine grow at a faster rate than does the spinal cord. This differential rate of growth continues after birth, into early childhood. At birth the lower-most part of the spinal cord (known as the conus) lies level with the 3rd lumbar vertebra. By late adolescence it has risen to a point level with the 1st lumbar vertebra, in which position it remains throughout adult life. Sometimes, however, the conus does not rise in this way and is then described as being low-lying, or tethered. Sometimes such tethering can generate pain and neurological symptoms, particularly during the adolescent growth spurt. Sometimes, therefore, there may be a role for surgical “untethering”ofalow-lyingcordinanadolescentpatient. Itremainsamatterof uncertainty as to whether such surgery has a role in later adult life.