Inclusion Criteria:  Male or female ≥ 2 and < 80 years of age. Refractory to medical management of symptoms for at least 1 year. Documentation of OTCS, as defined by a total score of at least 30 on the following scale:  OCCULT Grading Scale (Score 0-100) Orthopedic Abnormality: 0-15; Central Nervous System Dysfunction: 0-25; Cutaneous Stigmata: 0-10; Urological or Bowel Dysfunction: 0-25; Lumbosacral Anatomy: 0-15; Tissue Integrity Disorder: 0-10.  Exclusion Criteria:  Subjects < 2 or > 80 years of age.  Radiographically identified tethered cord, as defined by any of the following:  A low-lying conus (at or below the L2-3 disc space) A thickened filum (>2 mm) Fat in the filum or lipoma Distinct adhesion or tethering. A history of Meningocele manqué or Myelomeningocele. Cutaneous markings of dermal sinus tract. History of prior surgery on the lumbar spine. History of prior surgery for spinal dysraphism.