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Acta Neurochir (Wien). 2005 May;147(5):515-23; discussion 523.

Results of the section of the filum terminale in 20 patients with syringomyelia, scoliosis and Chiari malformation.

Author information

1
Barcelona Neurological Institute, Barcelona, Spain. neurologic@comb.es

Abstract

BACKGROUND:

Spinal cord traction caused by a tight filum terminale may be considered a pathogenic mechanism involved in the development of syringomyelia, the Chiari malformation (type I) and scoliosis. Section of the filum terminale is proposed as a useful surgical approach in these conditions.

METHODS:

Between April 1993 and July 2003, a total of 20 patients (8 men and 12 women) with a mean age of 33.5 years underwent section of the filum terminale with or without opening of the dural sac through a standard sacrectomy. Eight patients suffered from scoliosis, 5 from syringomyelia, 2 from Chiari malformation and 5 with a combination of these conditions.

FINDING:

After section of the filum terminale, patients with syringomyelia showed an early clinical improvement of dysaesthesia, thermo-anaesthesia, hypo-aesthesia and walking difficulties. Rising of the medullary conus was also observed. In patients with scoliosis, back pain improved dramatically and a curve reduction was noticed, although progression of the curve was observed in one case. In patients with Chiari malformation, headache, dysaesthesia and paraparesis disappeared.

CONCLUSIONS:

Section of the filum terminale is a useful strategy in the treatment of scoliosis, syringomyelia and the Chiari malformation, and offers a new aetiological basis for the understanding of these three disorders.

PMID:
15723156
DOI:
10.1007/s00701-005-0482-y
[Indexed for MEDLINE]

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