Introduction
There are a number of skin abnormalities that occur along the midline of the back that are indicative of an underlying abnormality of the spinal cord. The great majority of these "neurocutaneous signatures" occur in the region of the small of the back just above the hip bone (the spine's lumbar-sacral junction) and are associated with a "tethered cord" (a spinal cord unable to move because of its being held by surrounding tissues). Most infants with this condition are neurologically normal at birth, and for this reason, it is essential to recognize the association between the neurocutaneous signature and the underlying pathology inasmuch as progressive neurological dysfunction usually occurs in the absence of satisfactory treatment.