Tethered spinal cord syndrome occurs when the spinal cord does not hang freely in the spinal canal but instead is attached at the coccyx. It has a variety of identifying characteristics, including external manifestations such as lipomas or fatty tumors, skin tags, sacral dimple, benign tumors composed of blood vessels, excessive growth of hair in the middle of the lumbar and thoracic region, a lesion resembling a cigarette burn, or asymmetrical buttock creases. There may also be orthopedic deformities, such as scoliosis or muscle atrophy in feet and legs, urological difficulties, and neurological manifestations such as decreased sensation and reflexes in the lower extremities.