ABSTRACT
This chapter provides an overview of the workup and symptomatology of tethered cord syndrome (TCS), with a focus on the urologic complications and the ensuing management options for the clinician. TCS is a functional disorder of the spinal cord caused by pathologic anchoring of its caudal end, causing neurologic dysfunction. The true incidence of occult spinal defects and more specifically, TCS, is unknown. TCS is diagnosed on workup for unrelated or possibly related disorders, such as imperforate anus. The presentation of TCS should be separated into the two categories of pediatric presentation and adult presentation in order to more accurately identify the symptomatology of which the clinician should be aware. The primary imaging modality for TCS is magnetic resonance imaging, but clinicians may rely on adjunct information from computed tomography and ultrasound. Treatment of TCS is primarily indicated in cases of progressive neurologic decline, including motor signs, orthopedic deformities, and incontinence.
