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A 32-year-old male patient was operated for tethered cord associated with spinal lipoma. Further investigations showed the presence of basilar invagination, Chiari formation, and extensive syringomyelia. His neurological symptoms continued to worsen after the surgery, and over a 3-year period, he developed spastic quadriparesis and urinary retention and constipation. The patient was now treated by atlantoaxial fixation. Following the surgery, the patient improved in function in all four limbs and both the urinary and stool control. The presence of symptomatic Chiari formation in association with the tethered cord is a relatively rare clinical event. Surgical treatment of Chiari formation can result in a gratifying clinical recovery.

Tethered cord and Chiari formation: Analysis of treatment in a relatively rare clinical situation