Results of the section of the filum terminale in 20 patients with syringomyelia,scoliosis and Chiari malformation |
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Authors: | M B Royo-Salvador J Solé-Llenas J M Doménech R González-Adrio |
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Institution: | (1) Barcelona Neurological Institute, Barcelona, Spain;(2) Department of Neuroradiology, Universitat Autònoma de Barcelona, Barcelona, Spain;(3) Department of Anatomy, Universitat Autònoma de Barcelona, Barcelona, Spain;(4) FIATC Foundation, Barcelona, Spain |
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Abstract: | Summary 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. |
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Keywords: | : Syringomyelia idiopathic scoliosis Arnorld-Chiari malformation tight filum terminale filum section |
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