Tethered cord is defined as a low state of the conus medullaris below the second lumbar vertebra. Tethered cord syndrome is a neurological disorder caused by an abnormal stretching of the tethered cord usually seen with growth. We report two cases of tethered cord syndrome associated with pedal hyperkeratotic lesions. The first case was a 64-year-old woman who presented with dislocation of the fifth toe and hyperkeratotic lesions on the right sole. A physical examination revealed a soft normal-colored tumor on the central lower back. The second case was an 82-year-old woman with a complaint of a clavus with malum perforans pedis on the right sole. Hypesthesia of lower extremities were observed in both patients. Magnetic resonance imaging of the spine demonstrated tethered cord syndrome, which caused disturbances of skin sensation. One must be aware that chronic foot lesions, even in older patients, can be signs of neurological disorders due to spinal abnormality such as the tethered cord syndrome.
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