ABSTRACT
Children with anorectal malformations (ARM) may have an associated tethered spinal cord which can have lower extremity and bladder implications. A tethered cord refers to tension on the cord that worsens with growth due to pathologic fixation. The normal spinal cord is typically free to rise in the thecal sac with growth, while a tethered cord is abnormally low in the thecal sac. If restricted from freedom, the tension, concentrated on the distal cord, affects the lower spinal nerve roots because of mechanical stretching, distortion, and ischemia. These nerves primarily affect the lower extremity motor and sensory function as well as the bowel and bladder.
