The ventriculus terminalis and filum terminale of the human spinal cord

Choi, BongKyoo; Kim, Ronald C.; Suzuki, Michiyasu; Choe, Wonsick

doi:10.1016/0046-8177(92)90405-r

Cited by 62 publications

(46 citation statements)

References 23 publications

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“…This observation replicates that of 4 other much smaller histological studies of FT in patients with TCS. 4,9,10,12 In a series of presumably normal FTs from 4 fetuses, none of the specimens had evidence of fibrosis. 12 In another small series, normal FTs had thin collagen bundles and rare adipose tissue, whereas FTs from patients with urinary symptoms and hyperreflexive and hypertonic bladders on urodynamic testing had an increased amount of adipose connective and fibrous tissue.…”

Section: Discussionmentioning

confidence: 99%

“…A normal filum terminale (FT) is composed of glial fibers, peripheral nerves, blood vessels, fibrous connective tissue, adipose tissue, and ependymal cells. 4,9 Tethered cord syndrome may be due to thickened or fatty structural elements within the FT 2 that render it inappropriately tense, preventing normal stretching and movement as the spine flexes and extends. This mechanism would account for the pathophysiology of TCS due to a low-lying conus, in which FT tension had prevented normal spinal cord ascension during development.…”

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confidence: 99%

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Clinical significance of imaging and histological characteristics of filum terminale in tethered cord syndrome

Thompson¹,

Strong²,

Warren

et al. 2014

PED

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Object The pathophysiology of tethered cord syndrome (TCS) is uncertain; however, it has been suggested that fibrous and fatty elements within the filum terminale (FT) play a role. The objective of this study was to describe the radiological and histological features of the FT in TCS and determine if there are associations between those features and clinical outcomes, complications, and urodynamics. Methods In this retrospective study, histological, MRI, and clinical data obtained in 293 patients with TCS who underwent FT transection were reviewed and analyzed in a multivariate analysis. Results The median patient age was 4.9 years (range 0.3–64.3 years). On MRI, a fatty filum was present in 65% of patients and a thickened filum (> 2 mm) was seen in 45%. Histologically, the FT contained prominent fibrous tissue in 95%, nerve twigs in 79%, adipose tissue in 59%, and vascular tissue in 36%. Histological features associated with a thickened filum on MR images were adipose tissue (OR 3.5, p < 0.001), nerve twigs (OR 2.2, p = 0.028), and vascular tissue (OR 0.5, p = 0.025). Adipose tissue was associated with a conus level below the L2–3 disc space (OR 2.3, p = 0.031) and with a fatty filum on imaging (OR 9.8, p < 0.001). Nerve twigs were associated with abnormal urodynamics (OR 10.9, p = 0.049). The only variable predictive of clinical improvement was conus level; patients with conus levels caudal to L-2 were less likely to improve postoperatively (OR 0.3, p = 0.042). Conclusions Fibrous tissue was ubiquitous and may be important in the pathophysiology of TCS. Nerve twigs and adipose tissue were associated with abnormal urodynamics and low-lying coni, respectively. Although the majority of patients clinically improved, patients with normal conus levels had significantly better outcomes.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Clinical significance of imaging and histological characteristics of filum terminale in tethered cord syndrome

Thompson¹,

Strong²,

Warren

et al. 2014

PED

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“…So far, neither the physiologic role of the ventriculus terminalis nor the cause of its cystic dilatation has been defined [2]. The studies by Gardner and Williams studies [4,5] and Aboulker's theory [1] do not seem applicable to this lesion.…”

Section: Introductionmentioning

confidence: 99%

“…The cavity is lined with ependyma and usually rudimentary. A pathological study by Choi et al [2] demonstrated that the ventriculus terminalis was always detectable by histologic examination of the adult or pediatric conus medullaris, while neuroimaging techniques can hardly detect it.…”

Section: Introductionmentioning

confidence: 99%

Symptomatic cystic dilatation of V ventricle: Case report and review of the literature

1997

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“…It consists mostly of bundles of collagen fibers and some bundles of neurogenic tissue and is covered by the pia mater, extending from the conus throughout the intradural course. [1][2][3][4] Vascular anatomy of the filum is unique. Its arterial supply is from 1 single longitudinal axis, which is the caudal extension of the radiculomedullary and anterior spinal arteries.…”

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confidence: 99%

Spinal Arteriovenous Fistulas of the Filum Terminale

Lim¹,

Choi²,

David³

2011

AJNR Am J Neuroradiol

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SUMMARY:The filum terminale is an anatomic structure at the end of the spinal cord. Only a few cases of AVFs of the filum terminale have been reported. These AVFs usually consist of a single communication between the anterior spinal artery and a single draining vein. We retrospectively analyzed the clinical and radiologic features and treatment of 4 patients with spinal AVFs of the filum terminale. Clinical manifestations and MR images are similar to those of spinal dural AVFs. All patients underwent surgical or endovascular treatment, resulting in complete occlusion. Clinical outcomes were good to excellent in all patients. ABBREVIATIONS: ASA ϭ anterior spinal artery; AVF ϭ arteriovenous fistula; AVM ϭ arteriovenous malformation; AVS ϭ arteriovenous shunt; Endovas ϭ endovascular embolization; n-BCA ϭ n-butyl cyanoacrylate; SI ϭ signal intensity; SV ϭ signal voids T he filum terminale internum, commonly referred as the filum terminale, is a slender connective tissue filament, connecting the caudal apex of the conus medullaris at the L1-L2 level to the end of the dural tube at the second sacral level. It consists mostly of bundles of collagen fibers and some bundles of neurogenic tissue and is covered by the pia mater, extending from the conus throughout the intradural course.

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The ventriculus terminalis and filum terminale of the human spinal cord

Cited by 62 publications

References 23 publications

Clinical significance of imaging and histological characteristics of filum terminale in tethered cord syndrome

Clinical significance of imaging and histological characteristics of filum terminale in tethered cord syndrome

Symptomatic cystic dilatation of V ventricle: Case report and review of the literature

Spinal Arteriovenous Fistulas of the Filum Terminale

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