Retethering of sectioned fibrolipomatous filum terminale in an adult: case report and review of the literature

The Spine Journal : Official Journal of the North American Spine Society
Jonathan J Stone, Curtis J Rozzelle

Abstract

Recurrent tethering of the spinal cord is a rare late complication after sectioning of a fibrolipomatous filum terminale that has only been reported in two pediatric cases. To report adult-onset recurrent tethering of the spinal cord after surgical sectioning of a fibrolipomatous filum terminale and review the literature in an attempt to identify similar cases. The study was designed to be a case report and literature review. A 21-year-old woman with a history of previous surgical repair for a tethered spinal cord secondary to a fibrolipomatous filum terminale presented with low back and right lower extremity pain, urinary frequency, and fecal incontinence. Progressive bladder and sphincter dysfunction was confirmed on urodynamic testing. Lumbar spine magnetic resonance imaging demonstrated a low-lying and dorsally positioned conus medullaris. The patient underwent neurosurgical exploration of the previous site of sectioning with rerelease of the proximal fatty filum stump from dorsal dural adhesions. Postoperatively, her pain resolved, and her bowel and bladder control improved. Sectioning of both abnormal and apparently normal fila has become a relatively common procedure in pediatric neurosurgery. As more children with this ...Continue Reading

References

May 1, 1991·Journal of Neurosurgery·H SakamotoS Nishimura
Jan 7, 1999·Pediatric Neurosurgery·A ColakA L Albright
Aug 25, 2000·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·N OheN Sakai
Apr 13, 2002·Neurosurgery·Loi K PhuongCorey Raffel
Aug 5, 2004·Pediatric Neurosurgery·Monica C WehbyBenjamin J Richards
Mar 16, 2007·Journal of Neurosurgery. Spine·Sharad RajpalBermans J Iskandar
Apr 6, 2007·Pediatric Neurosurgery·Sean M Lew, Karl F Kothbauer
Oct 27, 2007·Neurosurgical Focus·Shokei YamadaAustin R T Colohan

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