We reported the surgical results of two patients with tethered cord syndrome. Case 1 was a 12-year-old girl complaining of low back pain, urinary incontinence, motor weakness, sensory disturbance of the lower extremities, and bilateral pes cavus. Radiological findings and MRI revealed the spina bifida of the sacrum, conus medullaris located at the L1 level, and the filum terminale running dorsally. The tight filum terminale was confirmed during surgery, and resection of the filum terminale allowed the caudal displacement of the conus by as much as 1cm. Five years after surgery, all the symptoms except the pes cavus improved. Case 2 was a 13-year-old boy complaining of gait disturbance and urinary incontinence. He showed cutaneous dimple on the sacral area. Although he showed hyperreflexia of the lower extremities, neither motor weakness nor sensory disturbance was seen. Images showed the spina bifida of L5 and sacrum, and low and dorsally placed conus medullaris at S1. During surgery, we confirmed a fibrous band connecting the sacral dimple with the dura, and thickened filum terminale. Resection of the filum terminale and release of the fibrous tissue allowed cranial displacement of the conus by 1cm. Five months after surgery, all the symptoms except the pes cavus improved.
