Which long-term concern is associated with spina bifida occulta?

• A. High rate of tethered cord
• B. Seizures
• C. Sudden onset paralysis in infancy
• D. No long-term issues

Answer: (A)

Tethered cord syndrome is the long‑term concern with spina bifida occulta. In occulta, the spinal cord may be abnormally attached or have subtle tissue connections that don’t cause problems at birth, but as a child grows these attachments can pull on the cord. That pulling stretches the cord over time, leading to progressive neurological and orthopedic problems rather than an acute event. You might see gradually worsening leg weakness or gait changes, back or leg pain, scoliosis or foot deformities, and new bladder or bowel symptoms. These symptoms develop gradually, which distinguishes tethered cord from sudden infant paralysis or seizures that aren’t typically tied to occult spinal defects. Some individuals remain asymptomatic, but tethered cord is a recognized long‑term risk, making it the best answer.