Document Detail


Retethering of sectioned fibrolipomatous filum terminale in an adult: case report and review of the literature.
MedLine Citation:
PMID:  20650405     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND CONTEXT: 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. PURPOSE: 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. STUDY DESIGN/SETTING: The study was designed to be a case report and literature review. METHODS: 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. RESULTS: 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. CONCLUSIONS: Sectioning of both abnormal and apparently normal fila has become a relatively common procedure in pediatric neurosurgery. As more children with this surgical history mature and present for neurosurgical consultation as adults, retethering must be considered in the differential diagnosis.
Authors:
Jonathan J Stone; Curtis J Rozzelle
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The spine journal : official journal of the North American Spine Society     Volume:  10     ISSN:  1878-1632     ISO Abbreviation:  Spine J     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-23     Completed Date:  2010-11-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101130732     Medline TA:  Spine J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e1-4     Citation Subset:  IM    
Copyright Information:
2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Neurosurgery, Women & Children's Hospital of Buffalo, Kaleida Health, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY 14222, USA.
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MeSH Terms
Descriptor/Qualifier:
Cauda Equina / pathology,  surgery*
Female
Humans
Lipoma / complications,  pathology,  surgery*
Low Back Pain / etiology,  surgery*
Magnetic Resonance Imaging
Neurosurgical Procedures
Peripheral Nervous System Neoplasms / complications,  pathology,  surgery*
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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