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Is a filum terminale with a normal appearance really normal?
Childs Nerv Syst. 2003 Jan; 19(1):3-10.CN

Abstract

INTRODUCTION

Tethered spinal cord is defined as a condition in which the conus medullaris ends at a level below the L1-2 intervertebral space. The spinal cord is considered to be tethered when there is a thick filum terminale or low-lying conus medullaris. It has also been reported that a normal level of the conus medullaris and normal thickness of the filum terminale do not mean that there is no cord tethering.

MATERIALS AND METHODS

In this investigation, we examined 21 fila terminalia; 5 of them were taken from cadavers, and these were used as a control group (group 1; n/n), 8 from patients with a normal appearance of the filum terminale but with clinical symptoms (incontinence) and pathologic results of a urodynamic study (group 2; n/ab), and 8 from patients with an abnormal appearance of the filum terminale and with clinical symptoms (group 3; ab/ab). Interestingly, we found that while fila terminalia in the control group were made up mainly of collagen fibers, more connective tissue with dense collagen fibers, some hyalinization and dilated capillaries were noticed in the fila from group 2.

RESULTS

Our results suggest that these histological features may reflect a decreased elasticity within the filum terminale, resulting in a tethering effect on the lower conus in otherwise normal physiological conditions.

CONCLUSION

These findings lead us to reconsider sectioning of the filum terminale in incontinent patients with normal results in radiological studies, whose condition is called "nonneurogenic neurogenic bladder."

Authors+Show Affiliations

Department of Neurosurgery, School of Medicine, Celal Bayar University, Manisa, Turkey. mselcuki@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

12541079

Citation

Selçuki, Mehmet, et al. "Is a Filum Terminale With a Normal Appearance Really Normal?" Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery, vol. 19, no. 1, 2003, pp. 3-10.
Selçuki M, Vatansever S, Inan S, et al. Is a filum terminale with a normal appearance really normal? Childs Nerv Syst. 2003;19(1):3-10.
Selçuki, M., Vatansever, S., Inan, S., Erdemli, E., Bağdatoğlu, C., & Polat, A. (2003). Is a filum terminale with a normal appearance really normal? Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery, 19(1), 3-10.
Selçuki M, et al. Is a Filum Terminale With a Normal Appearance Really Normal. Childs Nerv Syst. 2003;19(1):3-10. PubMed PMID: 12541079.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is a filum terminale with a normal appearance really normal? AU - Selçuki,Mehmet, AU - Vatansever,Seda, AU - Inan,Sevinç, AU - Erdemli,Esra, AU - Bağdatoğlu,Celal, AU - Polat,Ayse, Y1 - 2002/11/06/ PY - 2002/07/31/received PY - 2003/1/24/pubmed PY - 2003/5/15/medline PY - 2003/1/24/entrez SP - 3 EP - 10 JF - Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery JO - Childs Nerv Syst VL - 19 IS - 1 N2 - INTRODUCTION: Tethered spinal cord is defined as a condition in which the conus medullaris ends at a level below the L1-2 intervertebral space. The spinal cord is considered to be tethered when there is a thick filum terminale or low-lying conus medullaris. It has also been reported that a normal level of the conus medullaris and normal thickness of the filum terminale do not mean that there is no cord tethering. MATERIALS AND METHODS: In this investigation, we examined 21 fila terminalia; 5 of them were taken from cadavers, and these were used as a control group (group 1; n/n), 8 from patients with a normal appearance of the filum terminale but with clinical symptoms (incontinence) and pathologic results of a urodynamic study (group 2; n/ab), and 8 from patients with an abnormal appearance of the filum terminale and with clinical symptoms (group 3; ab/ab). Interestingly, we found that while fila terminalia in the control group were made up mainly of collagen fibers, more connective tissue with dense collagen fibers, some hyalinization and dilated capillaries were noticed in the fila from group 2. RESULTS: Our results suggest that these histological features may reflect a decreased elasticity within the filum terminale, resulting in a tethering effect on the lower conus in otherwise normal physiological conditions. CONCLUSION: These findings lead us to reconsider sectioning of the filum terminale in incontinent patients with normal results in radiological studies, whose condition is called "nonneurogenic neurogenic bladder." SN - 0256-7040 UR - https://www.unboundmedicine.com/medline/citation/12541079/Is_a_filum_terminale_with_a_normal_appearance_really_normal L2 - https://dx.doi.org/10.1007/s00381-002-0665-1 DB - PRIME DP - Unbound Medicine ER -