Management of tight filum terminale.
OBJECTIVE
Tight filum terminale (TFT) is not an uncommon condition, but due to insufficient diagnostic options this syndrome is often overlooked and left untreated. The present study was designed to investigate surgical results concerning neurological perspectives and diagnostic methods for TFT.


METHODS
Subjects for this study consisted of 37 patients with TFT who were surgically treated by transecting the filum terminale. We examined the surgical outcomes with regard to low back pain, leg pain, and bladder and bowel dysfunctions, and analyzed neurological and imaging findings.


RESULTS
TFT diagnosis was based on the following five criteria; 1) low back pain, 2) non-dermatomal leg pain, 3) bladder-bowel dysfunction, 4) spinal stiffness, and 5) a newly developed positive provocation test for spinal cord extension.


CONCLUSIONS
The survey of surgical outcomes indicated that satisfactory results could be obtained by surgical release of the filum terminale, while neural function was still reversible. In particular, our newly devised provocation test was shown to be highly effective for the early diagnosis of this disorder.
Komagata
M
M
Department of Orthopaedic Surgery, Tokyo Medical University, Tokyo, Japan. komagatam@mail.goo.ne.jp
Endo
K
K
Nishiyama
M
M
Ikegami
H
H
Imakiire
A
A
D000293:Adolescent; D000328:Adult; D002420:Cauda Equina / Q000002:abnormalities* / Q000503:physiopathology / Q000601:surgery*; D005071:Evoked Potentials; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007422:Intestines / Q000503:physiopathology; D017116:Low Back Pain / Q000209:etiology; D008297:Male; D009192:Myelography; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*; D020127:Recovery of Function / Q000502:physiology; D013131:Spine / Q000503:physiopathology; D013577:Syndrome; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000503:physiopathology