Spinal dysraphism is a group of anomalies resulting in disorganized spinal column and cord, in our case there are four characteristic findings; cord lipoma seen attached to the lower part of the tethered cord and should be differentiated from the dural lipoma that is seen also a dysraphic feature, the differentiation based on the thecal sac wall as a line of discrimination , in our case the lipoma seen inside the thecal sac while the opposite favors the possibility of dural lipoma, spina bifida and dermal sinus support such diagnosis.

The bony skeleton often shows dysraphic features like butterfly or hemivertebra which are characteristic but not present in our case.

The presence of meningo- or meningomyelocele is a strong evidence but also not present in our case.