Document Detail

Gross and microscopic study of the filum terminale: does the filum contain functional neural elements?
MedLine Citation:
PMID:  22208327     Owner:  NLM     Status:  MEDLINE    
OBJECT: The filum terminale (FT) is considered a fibrous structure that extends from conus medullaris of the spinal cord to coccyx. Based on previous studies and from their own experience with intraoperative electrophysiological monitoring of the sacral nervous system, the authors postulate that the FT contains functional neural elements in some individuals.
METHODS: The FT was dissected from 13 fresh stillborn cadavers (7 male, 6 female; mean gestational age 36 weeks and 1 day). The gross anatomical features were recorded, and connections between the FT and the nerve roots of the cauda equina were noted. These connections, when present, were sectioned for histological studies. The fila (both interna and externa) were also sectioned for histological and immunohistochemical studies. In addition, FT specimens were obtained from 5 patients undergoing sectioning of the FT in an untethering surgical procedure.
RESULTS: There were 5 gross connections between the FT and nerve roots demonstrating nerve fibers that were positive for S100. The FT showed islands of cells that were positive for GFAP in 10 cases, synaptophysin in 3 cases, S100 in 11 cases, and nestin in 2 cases. The nerve fibers in the FT were myelinated in 2 cases. The conus ended at the L-1 or L-2 vertebral level in all 13 specimens. The dural sac terminated at the S-2 vertebral level in most of the specimens. The 5 FT specimens that were obtained from patients revealed nerve bundles that were positive for S100 in 4 cases and cells that were positive for GFAP in 3 cases.
CONCLUSIONS: There are gross anatomical connections between the FT and nerve roots that contain nerve fibers. Apart from fibrous stroma, the FT may contain nerve bundles and cells that stain positive for GFAP, synaptophysin, S100, and nestin. These microscopic findings and previous intraoperative electrophysiological studies suggest a probable functional role for the FT in some individuals. At birth, the conus ends at a higher vertebral level (lower L-1 or upper L-2) than L-3.
Samson Sujit Kumar Gaddam; Vissa Santhi; Srinivasa Babu; Geeta Chacko; Ramakrishna Appala Baddukonda; Vedantam Rajshekhar
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of neurosurgery. Pediatrics     Volume:  9     ISSN:  1933-0715     ISO Abbreviation:  J Neurosurg Pediatr     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-02     Completed Date:  2012-02-13     Revised Date:  2013-05-10    
Medline Journal Info:
Nlm Unique ID:  101463759     Medline TA:  J Neurosurg Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  86-92     Citation Subset:  IM    
Department of Neurosurgery, Narayana Medical College, Nellore, India.
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MeSH Terms
Cauda Equina / pathology*
Glial Fibrillary Acidic Protein / analysis
Infant, Newborn
Intermediate Filament Proteins / analysis
Nerve Fibers / pathology
Nerve Tissue Proteins / analysis
Neural Pathways / pathology
Neural Tube Defects / parasitology,  pathology,  surgery
Reference Values
S100 Proteins / analysis
Spinal Nerve Roots / pathology*
Synaptophysin / analysis
Reg. No./Substance:
0/Glial Fibrillary Acidic Protein; 0/Intermediate Filament Proteins; 0/Nerve Tissue Proteins; 0/S100 Proteins; 0/Synaptophysin; 0/nestin
Comment In:
J Neurosurg Pediatr. 2013 Apr;11(4):485   [PMID:  23350680 ]
J Neurosurg Pediatr. 2013 Apr;11(4):485

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