Duplicated filum terminale in non-split cord malformations: An underrecognized cause for treatment failure in tethered cord syndrome.

Détails

ID Serval
serval:BIB_16810A5BBEBD
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Titre
Duplicated filum terminale in non-split cord malformations: An underrecognized cause for treatment failure in tethered cord syndrome.
Périodique
The journal of spinal cord medicine
Auteur(s)
Starnoni D., Duff J.M., Chittur Viswanathan G.
ISSN
2045-7723 (Electronic)
ISSN-L
1079-0268
Statut éditorial
Publié
Date de publication
07/2017
Peer-reviewed
Oui
Volume
40
Numéro
4
Pages
481-484
Langue
anglais
Notes
Publication types: Case Reports ; Journal Article
Publication Status: ppublish
Résumé
Anatomical variations of the filum terminale (FT) have been described in association with split cord malformations (SCM) but they appear to be a rare finding in its absence. We report the first case in literature of a duplicated FT in a patient presenting with tethered cord syndrome (TCS) without any radiological evidence of SCM.
A 47-year-old man presented with invalidating back pain radiating to both legs. Magnetic resonance imaging revealed an intradural dorsal lipoma in a low-lying conus. Intraoperatively two distinct fibrous bands were anatomically and electrophysiologically identified as the FT and both were sectioned. The diagnosis of FT was confirmed for both specimens by histology.
In absence of SCM, a duplicated FT has not been previously described as a cause of TCS. It may be a cause of treatment failure for TCS if unrecognized on preoperative imaging and during surgery if one filum remains intact. We highlight the importance of a meticulous cauda equina dissection supported by intraoperative nerve stimulation to identify this rare anomaly. We hypothesize that this entity may represent a variant of SCM involving the caudal neural tube but which requires further validation at an embryological level.

Mots-clé
Cauda Equina/abnormalities, Cauda Equina/diagnostic imaging, Diagnostic Errors, Humans, Male, Middle Aged, Neural Tube Defects/diagnostic imaging, Neural Tube Defects/pathology, Neural Tube Defects/surgery, Postoperative Complications/etiology, Conus medullaris, Filum terminale, Spinal cord, Split cord malformation, Tethered cord syndrome
Pubmed
Web of science
Création de la notice
25/10/2016 19:27
Dernière modification de la notice
20/08/2019 13:46
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