The borderlands of the primary tethered cord syndrome

The PTCS is easily dealt with surgically with little risk of additional injury. The likelihood of some improvement in neurologic function and the elimination of pain is high, with the exception of the neurogenic bladder. In the patient with the position of the conus over the L3 vertebral body of below, the rationale of therapeutic or prophylactic surgery is clear. As for the patient with progressive symptoms attributable to the PTCS, and in the young asymptomatic child or infant if the conus is above the L2-L3 disc space, the patient should be assessed in the context of the other associated anomalies present.