Spina bifida occulta: early clinical and radiographic diagnosis.

Tethered cord syndrome (TCS) is produced by traction of the lumbosacral spinal cord. Clinically, patients with tethered cord syndrome present with various combinations of neurologic, orthopedic, and cutaneous abnormalities. These abnormalities are often subtle. Early diagnosis, and treatment when indicated, is essential to prevent progressive and frequently irreversible neurological deterioration. Early diagnosis is aided by a high degree of clinical suspicion. Plain spine films are useful in the preliminary evaluation of suspected dysraphism. When plain film abnormalities are present, magnetic resonance imaging (MRI) has been found to be the single most effective procedure for both initial diagnosis and pre-operative evaluation of patients with myelodysplasia.