Mechanical relationship of filum terminale externum and filum terminale internum: is it possible to detether the spinal cord extradurally?

Patel, Mayank; Vetter, Marc; Simonds, Emily; Schumacher, Maia; Laws, Tyler; Iwanaga, Joe; Oskouian, Rod J.; Tubbs, R. Shane

doi:10.1007/s00381-018-3837-3

Cited by 6 publications

(5 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After that, it descends to the dorsal periosteum of coccyx (Tubbs et al, ). Previously, quantitated by Patel et al (), the study demonstrated minimal mechanical influence of extradural tension at the FTe upon the FTi and conus medullaris. As a result of this report which showed trivial correlation of the two parts of FT, hence, our focus was exclusively on the site of FTi fusion with dura mater for its clinical relevance.…”

Section: Introductionmentioning

confidence: 82%

Spinal dural sac termination and internal filum terminale fusion

Pokanan

Borsu²,

Hansasuta

2019

Clinical Anatomy

View full text Add to dashboard Cite

Surgery for tethered spinal cord caused by thickened filum terminale (FT) is frequently performed through S1 laminectomy based on the assumption that the internal FT (FTi) fuses with dura mater at S2 vertebral level. Literature on specific study for the site of its fusion and dural sac (DS) termination was rather limited. Moreover, there is no large anatomical study in Asian population. To determine the anatomy, examination of the FTi fusion site, as well as the region at which DS ended, was undertaken. From 80 embalmed cadavers, the majority of FTi fusion occurred at, or below, S1/S2 disk space (62.5%) which was less frequent than previous reports (70%-90%). In addition, there was 11.3% of the fila that fused above S1. Regarding the DS termination, it was found at, or below, S1/S2 disk space in 76.3% with one subject (1.3%) at L5/S1 disk space. With modest differences compared with non-Asian cadaveric data, our results offer pertinent information to surgeons performing tethered cord release. One ought to keep in mind that small, but not negligible, percentage of FTi can fuse with dura mater above S1 level; hence, more rostral laminectomy at L5 may be required. Clin. Anat. 33:558-561, 2020.

show abstract

Section: Introductionmentioning

confidence: 82%

Spinal dural sac termination and internal filum terminale fusion

Pokanan

Borsu²,

Hansasuta

2019

Clinical Anatomy

View full text Add to dashboard Cite

show abstract

“…It protects the conus medullaris from traction, together with the dentate ligaments [13]. However, the FTE has no obvious effect on the conus medullaris or cauda equine [28]. The FT has an elastic structure, while elastic fibers are decreased in children with TCS [12,16].…”

Section: Discussionmentioning

confidence: 99%

“…This may be performed through the same surgical incision if the TCS is secondary to open spinal dysraphism, or via an endoscopic approach which provides a smaller skin incision, narrow durotomy, and minimal tissue damage [9,11]. Isolated transection of the FTE via an extradural approach for a patient with TCS has no significant effect on the release of the spinal cord [28]. In our patients with TCS, we performed an open surgical approach and released the spinal cord using microsurgical techniques and under intraoperative neuromonitoring.…”

Section: Discussionmentioning

confidence: 99%

Expression of Sigma-Class Glutathione-S-Transferase in Fetal and Pediatric Filum Terminale Samples: A Comparative Study

et al. 2019

View full text Add to dashboard Cite

Background and objectives: The pathophysiology of tethered cord syndrome (TCS) in children is not well elucidated. An inelastic filum terminale (FT) is the main factor underlying the stretching of the spinal cord in TCS. Our study aimed to investigate the expression of glutathione-S-transferase (GST) in children and fetal FT samples in order to understand the relationship between this enzyme expression and the development of TCS. Materials and Methods: FT samples were obtained from ten children with TCS (Group 1) and histological and immunohistochemical examinations were performed. For comparison, FT samples from fifteen normal human fetuses (Group 2) were also analyzed using the same techniques. Statistical comparison was made using a Chi-square test. Results: Positive GST-sigma expression was detected in eight (80%) of 10 samples in Group 1. The positive GST-sigma expression was less frequent in nine (60%) of 15 samples from Group 2. No statistically significant difference was detected between the two groups (p = 0.197). Conclusions: Decreased FT elasticity in TCS may be associated with increased GST expression in FT. More prospective studies are needed to clarify the mechanism of the GST–TCS relationship in children.

show abstract

“…3,4 This extradural segment has been postulated to have a minimal effect on tethering, requiring intradural sectioning to relieve tethering symptoms. 5 The patient is a 24-year-old woman who presented with burning pain of her lower extremities for 4 months. Her symptoms began 1 month after a cesarean section.…”

mentioning

confidence: 99%

“…3,4 This extradural segment has been postulated to have a minimal effect on tethering, requiring intradural sectioning to relieve tethering symptoms. 5…”

mentioning

confidence: 99%

High-Riding Filum Terminale Externum: 2-Dimensional Operative Video

Davidar,

Xia,

Sacino

et al. 2023

Operative Neurosurgery

View full text Add to dashboard Cite

Mechanical relationship of filum terminale externum and filum terminale internum: is it possible to detether the spinal cord extradurally?

Cited by 6 publications

References 22 publications

Spinal dural sac termination and internal filum terminale fusion

Spinal dural sac termination and internal filum terminale fusion

Expression of Sigma-Class Glutathione-S-Transferase in Fetal and Pediatric Filum Terminale Samples: A Comparative Study

High-Riding Filum Terminale Externum: 2-Dimensional Operative Video

Contact Info

Product

Resources

About