The Filum Terminale Syndrome

Management of Tight Filum Terminale

“…In 1953, Garceau reported 3 cases with neurological symptoms caused by an abnormal condition of the filum terminale, initially referred to as ªfilum terminale syndromeº, which were ameliorated following transection of the filum terminale [1]. A number of other cases concerning filum terminale syndrome or TFT have since been reported [2, 3].…”

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IntroductionIn 1953, Garceau reported 3 cases with neurological symptoms caused by an abnormal condition of the filum terminale, initially referred to as ªfilum terminale syndromeº, which were ameliorated following transection of the filum terminale [1]. A number of other cases concerning filum terminale syndrome or TFT have since been reported [2, 3].

However, TFT has been considered an unusual disorder of the spinal cord and is often overlooked due to the lack of effective diagnostic techniques available.

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The Tethered Spinal Cord: Its Protean Manifestations, Diagnosis and Surgical Correction

“…In 1953, Garceau [1] described the 'filum terminale syndrome' in three patients with a progressive neurological deficit involving lower limbs or bladder or both, who had a thick, tight filum terminale discov ered at laminectomy and who improved following section of the filum ter minale. In 1956, Jones and Love [4] reported six patients with a tight fil um terminale but two of these, in addition, had overlying meningoceles and one had an intraspinal meningocele.…”

Occult Filum terminale Syndrome

“…Prior to 1953, the neurological, urological and or thopedic manifestations associated with spina bifida oc culta (SBO) were referred to as occult spinal dysraphism or myelodysplasia [1][2][3][4][5], In 1953, Garceau [6] defined the filum terminale syndrome to describe spinal cord traction symptoms associated with an abnormally thickened filum terminale producing tension on the lower spinal cord. Additional patients presenting with cord traction symp toms related to the filum terminale syndrome were then reported in patients with SBO [7.…”

“…Additional patients presenting with cord traction symp toms related to the filum terminale syndrome were then reported in patients with SBO [7. 8], The few well-docu mented patients [6][7][8], coupled with the inability to reli ably visualize the tip of the conus and filum terminale radiographically, however, made the filum terminale syn drome suspect as a clinical entity [8][9][10]. With the advent of supine lumbar myelography [11] and later CT/myelography [12,13], a radiographic definition of this syndrome (filum terminale thickness >2 mm and/or the tip of the conus medullaris extending below the L2 vertebral body) [11.…”