A Comparative Study of Histopathological Analysis of Filum Terminale in Patients with Tethered Cord Syndrome and in Normal Human Fetuses

Tehli, Özkan; Hodaj, İrgen; Kural, Cahit; Solmaz, İlker; Öngürü, Önder; İzci, Yusuf

doi:10.1159/000338981

Cited by 26 publications

(25 citation statements)

References 23 publications

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“…The recent studies (10,18) such as; Tehli et al (18) report, in their comparative study of histopathological analysis of filum terminale between TCS patients and normal human fetuses, that adipose tissue, fibrosis, hyalinization, and meningothelial proliferation were observed in filum terminale samples of TCS patients, while none of these findings were observed in normal fetal samples. Elastic fibers were present in all TCS specimens and the adult cadaver, but were not observed in fetuses (10,18).…”

Section: █ Resultsmentioning

confidence: 99%

“…In our institute, in the last 10 years 93 adult patients were diagnosed with TC after permanent or severe and ependymal cells were observed in normal human fetal filum terminale samples (18). Because these changes are not observed in fetuses, they suggest that this syndrome did not begin in intrauterine life (18).…”

Section: █ Discussionmentioning

confidence: 98%

“…Filum terminale appears darker in color than nerve rootlets under the microscope. This aspect of filum terminale is related to its fibrovascular tag structure that contains a large vessel, which becomes smaller across through thecal sac (10,16,18). On the other hand, this vessel is not a reliable landmark for filum terminale (because similar vessels can be found on the rootlets or no vessel may be seen on filum terminale).…”

Section: Surgical Proceduresmentioning

confidence: 99%

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Management of tethered cord syndrome in adults: experience of 23 cases

Sofuoğlu

Abdallah²,

Emel³

et al. 2015

Turkish Neurosurgery

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ABSTRACTfrom folic acid deficiency. In contrast, TCS is rarely diagnosed in adults as well as it is a complex clinicopathological entity that remains poorly understood.The incidence of neural tube defects is 0.17-6.39 per 1000 live births worldwide (2). TCS is one of the common spinal dysraphic lesions which have been reduced in developed countries due to supplementation of folic acid during pregnancy and prenatal diagnosis of dysraphic malformations █ InTRODuCTIOn T ethered cord syndrome (TCS) is a deterioration involving an abnormal stretching of the tethered spinal cord, the ascent of which is limited and is disproportionate to the growth of the spinal column (9,13). TCS is not a rare pathological disorder particularly in developing countries. This congenital syndrome usually associates to other syndromes may develop in children who are born to mothers suffered AIM: Tethered cord syndrome (TCS) is rarely diagnosed in adults. It is a complex clinicopathological entity that remains poorly understood. In this study, clinical outcomes of 23 consecutive congenital TCSs diagnosed in adults have been evaluated to establish a standard approach to treat congenital TCS diagnosed in adults. MATERIAL and METhODS:Medical records were retrospectively reviewed in 73 cases of TCS who were underwent surgery in our hospital, between 2005 and 2014. Cases which diagnosed and treated surgically in adults (patient age > 18 years) were included in this study. RESuLTS:Twenty-three adult cases of TCSs were treated surgically and 15 of them were female and 8 were male. The mean age was 30.3±10.7 years. The mean follow-up period was 75.6±40.5 months. The most common complaint was low back pain. The most common findings in the neurological examinations were muscular weakness and urinary incontinence. The most common co-malformations were diastematomyelia and vertebral fusion anomalies. Conus medullaris was mostly terminated at the L5 level. Detethering procedure was carried out in 87% of patients and bony septum resection without detethering was applied in 13%. Laminoplasty was performed only in 39.1%. 60.9% of patients were recovered good. 34.8% of patients were improved. The most common complication was cerebrospinal fluid leakage.COnCLuSIOn: Despite the good results obtained in our surgical interventions for symptomatic TCS in adults, tethered cord releasing is complex procedure and has serious complications. Therefore, it is suggested to plan surgery according to symptoms emphasized with full neurological examination, craniospinal imaging and urodynamic tests.

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Section: █ Resultsmentioning

confidence: 99%

Section: █ Discussionmentioning

confidence: 98%

Section: Surgical Proceduresmentioning

confidence: 99%

See 1 more Smart Citation

Management of tethered cord syndrome in adults: experience of 23 cases

Sofuoğlu

Abdallah²,

Emel³

et al. 2015

Turkish Neurosurgery

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“…The other cause of the syndrome is not congenital, but usually the postoperative scar tissue, adhesions, and reactive tissues fix the spinal cord after spinal surgery, usually performed in childhood or early childhood (6,13,16,17). This is also called the "secondary TCS".…”

Section: Discussionmentioning

confidence: 99%

“…Orthopedic findings of the lower limb (ankle deformity, neurogenic claudication and shortening of the limbs -63%). Skin findings (hypertrichosis, lipoma, hemangiomas, dermal sinus -54%), urological problems (40%), scoliosis and kyphosis (29%) are other symptoms (1,3,5,9,12,13). In the radiological examinations of these patients, spina bifida was found in the lumbar or sacral region in 98% of the cases.…”

Section: Introductionmentioning

confidence: 98%

Tethered cord syndrome: 5 year clinical experiences and surgical results

Kacar¹,

Mehtiyev²,

Ramikhanov³

et al. 2018

J Turgut Ozal Med Cent

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Aim: Occult spinal dysraphism, which manifests with motor and sensory disturbances in children and causes orthopedic deformities in the lower extremities and urological findings, is the result of developmental defects in the caudal part of the neural tube. One of the most common spinal dysraphism is tethered cord syndrome (TCS). In this study, patients who had been diagnosed with TCS in the past 5 years were retrospectively reviewed and clinical, radiological and surgical characteristics of these patients were tried to be revealed. Material and Methods:We retrospectively reviewed the data about 26 patients with the diagnosis of TCS in our clinic between 2011-2015. The results of these surgeries were evaluated by age, gender, additional malformations, clinic symptoms, radiological and electrophysiological evaluation. The patient with urological symptoms was additionally performed in urodynamic tests. Results: These 26 cases, 23% were children and 77% were adults. 81% of the patients were male and 19% female. Only 3.8% of the patients were primary TCS, 96.2% of the patients had other malformations. Urine incontinence was found in 19.2% of the patients and orthopedic deformities were found in 7.7% of the patients. Surgical treatment was done to 65% of the patients, and 35% of the patients were followed because they didn't want to be operated. Conclusion: Tethered cord syndrome is usually not seem alone, it is associated with other developmental defects of the spine and spinal cord. If surgery done earlier, the greater the likelihood of regression of the neurological deficit or stablization the deficits.

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Adult Presentations/Outcomes of Occult Spinal Dysraphism

Abdallah

2019

Occult Spinal Dysraphism

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A Comparative Study of Histopathological Analysis of Filum Terminale in Patients with Tethered Cord Syndrome and in Normal Human Fetuses

Cited by 26 publications

References 23 publications

Management of tethered cord syndrome in adults: experience of 23 cases

Management of tethered cord syndrome in adults: experience of 23 cases

Tethered cord syndrome: 5 year clinical experiences and surgical results

Adult Presentations/Outcomes of Occult Spinal Dysraphism

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