Related Experiment Videos
Untethered filum terminale presenting as cauda equina lesion
1Department of Neurological Surgery, Medical University of South Carolina, Charleston, S.C., USA.
Pediatric Neurosurgery
|September 10, 1998
Summary
Recurrent bladder dysfunction in a child was linked to spinal cord issues. Surgery improved symptoms, but a new spinal lesion later required reoperation for a thickened filum terminale.
Area of Science:
- Pediatric Urology
- Neurosurgery
- Spinal Cord Medicine
Background:
- Recurrent bladder dysfunction can indicate underlying neurological conditions.
- Spinal cord abnormalities, such as a low-lying conus medullaris, may present with urologic symptoms.
Observation:
- A young girl presented with recurrent bladder dysfunction.
- Initial evaluation revealed a low-lying conus medullaris, treated with L5 laminectomy and filum terminale sectioning.
- Symptoms recurred 4 years post-surgery, with repeat imaging showing a new intradural lesion at L2.
Findings:
- The recurrent symptoms were associated with a newly identified, untethered, thickened, and coiled filum terminale at L2.
- This suggests potential for filum terminale abnormalities to cause delayed or recurrent neurological deficits.
Implications:
- This case highlights the importance of considering spinal cord pathology in pediatric recurrent bladder dysfunction.
- Re-evaluation and surgical intervention may be necessary for persistent or recurrent symptoms after initial spinal cord untethering.
- Understanding filum terminale morphology and its potential for secondary changes is crucial for long-term patient management.