Skip to main content

Advertisement

SpringerLink
Log in

Section of the filum terminale: is it worthwhile in Chiari type I malformation?

  • Associated Malformations
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

A section of the filum terminale (SFT) is used for the surgical treatment of isolated tethered cord or that resulting from neurulation disorders. More recently, it has been proposed for the management of the occult tethered cord syndrome (OTCS), though it is still under debate. Even more controversial appears to be the use of SFT in patients with Chiari type I malformation (CIM), which is based on the possible presence of OTCS. This review shows that: (1) there are issues both in favor and against the occurrence of OTCS, (2) there is no significant correlation between CIM and tethered cord, the old “caudal traction theory” being not supported by clinical or experimental evidences. On these grounds, a relationship between CIM and OTCS is hard to be demonstrated, (3) a subgroup of patients with CIM suffering from OTCS may exist and benefit from SFT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Milhorat TH, Bolognese PA, Nishikawa M, Francomano CA, McDobbell NB, Roonprapunt C, Kula RW (2009) Association of Chiari malformation type I and tethered cord syndrome: preliminary results of sectioning filum terminale. Surg Neurol 72:20–35

    Article  PubMed  Google Scholar 

  2. Abel TJ, Chowdhary A, Gabikian P, Ellenbogen RD, Avellino AM (2006) Acquired Chiari malformation type I associated with a fatty terminal filum: case report. J Neurosurg 105:329–332

    PubMed  Google Scholar 

  3. Selçuki M, Vatansever S, Inan S, Erdemli E, Bagdatoglu C, Polat A (2003) Is a filum terminale with a normal appearance really normal? Childs Nerv Syst 19:3–10

    PubMed  Google Scholar 

  4. Selden NR, Nixon RR, Skoog SR, Lashley DB (2006) Minimal tethered cord syndrome associated with thickening of the terminal filum. J Neurosurg 105:214–218

    PubMed  Google Scholar 

  5. Tubbs RS, Oakes WJ (2004) Can the conus medullaris in normal position be tethered? Neurol Res 26:727–731

    Article  PubMed  Google Scholar 

  6. Wehby MC, O’Hollaren PS, Abtin K, Hume JL, Richards BJ (2004) Occult tight filum terminale syndrome: results of surgical untethering. Pediatr Neurosurg 40:51–58

    Article  PubMed  Google Scholar 

  7. Drake JM (2006) Occult tethered cord syndrome: not an indication for surgery. J Neurosurg 104:305–308

    Article  PubMed  Google Scholar 

  8. Selden NR (2007) Minimal tethered cord syndrome: what’s necessary to justify a new surgical indication? Neurosurg Focus 23:E1

    Article  PubMed  Google Scholar 

  9. Sureshkumar P, Craig JC, Roy LP, Knight JF (2000) Daytime urinary incontinence in primary school children: a population-based survey. J Pediatr 137:814–818

    Article  PubMed  CAS  Google Scholar 

  10. Royo-Salvador MB, Solé-Llenas J, Doménech JM, González-Adrio R (2005) Results of the section of the filum terminale in 20 patients with syringomyelia, scoliosis and Chiari malformation. Acta Neurochir 147:515–523

    Article  CAS  Google Scholar 

  11. Gluncic V, Turner M, Burrowes D, Frim D (2011) Concurrent Chiari decompression and spinal cord untethering in children: feasibility in a small case series. Acta Neurochir (Wien). 153(1):109–114

    Article  Google Scholar 

  12. Tubbs RS, Bui CJ, Rice WC, Loukas M, Naftel RP, Holcombe MP, Oakes WJ (2007) Critical analysis of the Chiari malformation type I found in children with lipomyelomeningocele. J Neurosurg 106:196–200

    Article  PubMed  Google Scholar 

  13. Tubbs RS, Loukas M, Shoja MM, Oakes WJ (2007) Observations at the craniocervical junction with simultaneous caudal traction of the spinal cord. Childs Nerv Syst 23:367–369

    Article  PubMed  Google Scholar 

  14. Steinbok P, Kariyattil R, MacNeily AE (2007) Comparison of section of filum terminale and non-neurosurgical management for urinary incontinence in patients with normal conus position and possible occult tethered cord syndrome. Neurosurgery 61:550–556

    Article  PubMed  Google Scholar 

  15. Bauer DF, Tubbs RS, Chambers MR (2009) Study of the effects of flexion on the position of the conus medullaris: follow-up study using MR imaging in non-human primates. Childs Nerv Syst 25:977–979

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that there is no actual or potential conflict of interest in relation to this article.

Author information

Authors and Affiliations

  1. Department of Neurosciences, Pediatric Neurosurgery, A. Gemelli Hospital, Rome, Italy

    Luca Massimi, Simone Peraio, Elisabetta Peppucci, Gianpiero Tamburrini & Concezio Di Rocco

  2. Istituto di Neurochirurgia, Largo A. Gemelli, 8, 00168, Rome, Italy

    Luca Massimi

Authors
  1. Luca Massimi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Simone Peraio
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elisabetta Peppucci
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gianpiero Tamburrini
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Concezio Di Rocco
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Luca Massimi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Massimi, L., Peraio, S., Peppucci, E. et al. Section of the filum terminale: is it worthwhile in Chiari type I malformation?. Neurol Sci 32 (Suppl 3), 349–351 (2011). https://doi.org/10.1007/s10072-011-0691-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-011-0691-4

Keywords

Search

Navigation