Microsurgical approach for resection of the filum terminale internum in tethered cord syndrome—a case demonstration of technical nuances and vignettes

Background In tethered cord syndrome due to filum terminale pathology, the surgical approach to achieve detethering of the spinal cord may vary. Traditionally, sectioning the filum through a laminectomy at the lumbosacral level is performed. Method A microsurgical technique at a higher level to appr...

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Published inActa neurochirurgica Vol. 165; no. 11; pp. 3505 - 3509
Main Authors Abdulrazeq, H., Shao, B., Sastry, R. A., Klinge, P. M.
Format Journal Article
LanguageEnglish
Published Vienna Springer Vienna 01.11.2023
Springer Nature B.V
Subjects
Epidural
How I Do it
Interventional Radiology
Magnetic resonance imaging
Medicine
Medicine & Public Health
Minimally Invasive Surgery
Neurological diseases
Neurology
Neuroradiology
Neurosurgery
Neurosurgical technique evaluation
Pathology
Sectioning
Spinal cord
Surgical Orthopedics
Urinary retention
Filum terminale pathology
Lumbosacral level
Tethered cord syndrome
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Summary:Background In tethered cord syndrome due to filum terminale pathology, the surgical approach to achieve detethering of the spinal cord may vary. Traditionally, sectioning the filum through a laminectomy at the lumbosacral level is performed. Method A microsurgical technique at a higher level to approach the filum below the conus tip is performed. This allows for removal of the entire distal portion of the filum through a limited interlaminar approach and dural opening. Conclusion We propose a technique to transect the filum terminale below the conus tip and extract the distal filum by releasing it from its intradural attachments to minimize any remnants of the filum terminale.
Bibliography:ObjectType-Article-1
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ISSN:0942-0940
0001-6268
0942-0940
DOI:10.1007/s00701-023-05568-9