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Related Experiment Videos

Is a filum terminale with a normal appearance really normal?

Mehmet Selçuki1, Seda Vatansever, Sevinç Inan

  • 1Department of Neurosurgery, School of Medicine, Celal Bayar University, Manisa, Turkey. mselcuki@yahoo.com

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|January 24, 2003
PubMed
Summary

Tethered spinal cord may occur even with normal imaging. Histological changes in the filum terminale, like dense collagen, indicate reduced elasticity and can cause tethering, impacting bladder function.

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Area of Science:

  • Neurology
  • Histopathology
  • Urology

Background:

  • Tethered spinal cord involves the conus medullaris ending below L1-2.
  • A thick filum terminale or low conus indicates tethering.
  • Normal imaging does not always exclude spinal cord tethering.

Purpose of the Study:

  • To investigate the histological characteristics of the filum terminale in patients with suspected spinal cord tethering.
  • To correlate filum terminale histology with clinical symptoms and urodynamic findings.

Main Methods:

  • Histological examination of 21 human fila terminalia.
  • Comparison of control group (cadavers) with two patient groups (normal filum/symptoms, abnormal filum/symptoms).
  • Analysis included collagen fiber density, connective tissue, hyalinization, and capillary status.

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Main Results:

  • Control group fila terminalia primarily composed of collagen fibers.
  • Patient group with normal filum appearance but symptoms showed increased connective tissue, dense collagen, hyalinization, and dilated capillaries.
  • These histological features suggest decreased filum terminale elasticity.

Conclusions:

  • Histological findings in the filum terminale may indicate a tethering effect on the conus medullaris, even with normal radiological appearance.
  • Reconsideration of filum terminale sectioning is suggested for incontinent patients with normal radiological studies, often diagnosed with "nonneurogenic neurogenic bladder."