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Minimal tethered cord syndrome associated with thickening of the terminal filum.
J Neurosurg. 2006 Sep; 105(3 Suppl):214-8.JN

Abstract

OBJECT

The authors investigated the occurrence of anatomical abnormalities of the terminal filum in children undergoing surgical filum lysis for minimal tethered cord syndrome (TCS).

METHODS

Five consecutive children (age range 6-12 years) with medically refractory voiding dysfunction but no magnetic resonance (MR) imaging-documented lumbosacral abnormality on 1.5-tesla sequences underwent preoperative urodynamic studies consisting of calibrated uroflowmetry, cystometrography, and voiding cystourethrography. Urodynamic bladder function was abnormal in each case. A sixth child (5 years of age) who had progressive lower-extremity weakness, gait abnormality, and voiding dysfunction, but in whom there was no MR imaging-documented lumbosacral abnormality, was also included. These six children experienced improved bladder function after terminal filum lysis. Histologically, the terminal filum in these patients was fattier, thicker, and more densely fibrous than that in three reference patients undergoing incidental terminal filum lysis during selective dorsal rhizotomy or resection of a lumbar dermal sinus tract. All four patients with voiding dysfunction who underwent postoperative urodynamic testing experienced corresponding improvement in bladder function.

CONCLUSIONS

Significant improvement of voiding dysfunction after surgical lysis of the terminal filum in children with MR imaging-documented normal lumbosacral spines was observed. In such children, in whom neurogenic dysfunction is identified by urodynamic testing, structural abnormalities of the terminal filum may exist. A prospective randomized controlled study of children undergoing surgical terminal filum lysis in cases of minimal TCS should be undertaken.

Authors+Show Affiliations

Division of Pediatric Neurosurgery, Department of Neurological Surgery, Oregon Health and Science University, Portland 97239, USA. seldenn@ohsu.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16970235

Citation

Selden, Nathan R., et al. "Minimal Tethered Cord Syndrome Associated With Thickening of the Terminal Filum." Journal of Neurosurgery, vol. 105, no. 3 Suppl, 2006, pp. 214-8.
Selden NR, Nixon RR, Skoog SR, et al. Minimal tethered cord syndrome associated with thickening of the terminal filum. J Neurosurg. 2006;105(3 Suppl):214-8.
Selden, N. R., Nixon, R. R., Skoog, S. R., & Lashley, D. B. (2006). Minimal tethered cord syndrome associated with thickening of the terminal filum. Journal of Neurosurgery, 105(3 Suppl), 214-8.
Selden NR, et al. Minimal Tethered Cord Syndrome Associated With Thickening of the Terminal Filum. J Neurosurg. 2006;105(3 Suppl):214-8. PubMed PMID: 16970235.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Minimal tethered cord syndrome associated with thickening of the terminal filum. AU - Selden,Nathan R, AU - Nixon,Randal R, AU - Skoog,Steven R, AU - Lashley,David B, PY - 2006/9/15/pubmed PY - 2006/10/21/medline PY - 2006/9/15/entrez SP - 214 EP - 8 JF - Journal of neurosurgery JO - J. Neurosurg. VL - 105 IS - 3 Suppl N2 - OBJECT: The authors investigated the occurrence of anatomical abnormalities of the terminal filum in children undergoing surgical filum lysis for minimal tethered cord syndrome (TCS). METHODS: Five consecutive children (age range 6-12 years) with medically refractory voiding dysfunction but no magnetic resonance (MR) imaging-documented lumbosacral abnormality on 1.5-tesla sequences underwent preoperative urodynamic studies consisting of calibrated uroflowmetry, cystometrography, and voiding cystourethrography. Urodynamic bladder function was abnormal in each case. A sixth child (5 years of age) who had progressive lower-extremity weakness, gait abnormality, and voiding dysfunction, but in whom there was no MR imaging-documented lumbosacral abnormality, was also included. These six children experienced improved bladder function after terminal filum lysis. Histologically, the terminal filum in these patients was fattier, thicker, and more densely fibrous than that in three reference patients undergoing incidental terminal filum lysis during selective dorsal rhizotomy or resection of a lumbar dermal sinus tract. All four patients with voiding dysfunction who underwent postoperative urodynamic testing experienced corresponding improvement in bladder function. CONCLUSIONS: Significant improvement of voiding dysfunction after surgical lysis of the terminal filum in children with MR imaging-documented normal lumbosacral spines was observed. In such children, in whom neurogenic dysfunction is identified by urodynamic testing, structural abnormalities of the terminal filum may exist. A prospective randomized controlled study of children undergoing surgical terminal filum lysis in cases of minimal TCS should be undertaken. SN - 0022-3085 UR - https://www.unboundmedicine.com/medline/citation/16970235/Minimal_tethered_cord_syndrome_associated_with_thickening_of_the_terminal_filum_ L2 - https://thejns.org/doi/10.3171/ped.2006.105.3.214 DB - PRIME DP - Unbound Medicine ER -