<s>[INST] How bad is this and I know it s not good. My 23 year old daughter has had to have surgery 2 times for tethered spinal cord and we just got MRI results and it s retethered again. Ugh she has complete effacement of the dorsal subarachnoid space from t 5 through t8 [/INST] Hi, Thanks for writing in. Tethered cord can recur after surgery in young adults. In many patients the cord remains tethered even after doctors have tried to release the cord by one or more surgical sessions. It is important that the surgical procedures include careful intramural dissection and meticulous wound and rural closure. There are cases where multiple revision procedures, vertebral column shortening has become an appropriate alternative to surgical tethering. Post op surgical complications are common if the patient does not follow instructions to prevent any CSF leakage. In some patients CSF diversion is also required. </s>