Tethered cord syndrome is a combination of sensory and motor symptoms that result from abnormal tension on the distal end of the spinal cord. Repeated attempts to relieve this tension through traditional untethering approaches result in more surgical complications, including re-tethering, and less clinical benefit—the law of diminishing returns. However, spinal column shortening may be a safe and effective treatment option for recurrent tethered cord, obviating the drawbacks of repeated untethering surgery.