BAO Nan,WU Shui-hua,YANG Bo,et al.Diagnosis and treatment of tight filum terminale syndrome in children.[J].Journal of Clinical Pediatric Surgery,,9():0.
Diagnosis and treatment of tight filum terminale syndrome in children.
- Keywords:
- Neural Tube Defects; Diagnosis; Therapy
- Abstract:
- Objective Tight filum terminale syndrome (TFTS) characterized by findings consistent with a tethered cord but with the conus ending in a normal position has only recently been observed in children. In this situation, diagnosis may prove difficult and sectioning of the filum terminale is questionable. Methods Sixty cases of pediatric TFTS were analyzed by methods including spinal X-ray and MRI. Twenty-one patients exhibited a normally positioned conus, 18 a low-lying conus cases, and 21 a low-lying conus cases accompanying lumbosacral lipoma. These three groups were compared pre- and post-operatively for lumbosacral cutaneous stigmata, vertebral anomalies, concomitant congenital spinal dysraphisms, lower limb deformities, and sphincter dysfunction. Results Rates of occurrence of lumbosacral cutaneous stigmata and other concomitant congenital spinal dysraphisms differed significantly among these groups. Differences in other parameters were not observed. All groups responded positively to surgery. Conclusions Pediatric TFTS may involve a normally positioned conus. Diagnosis of pediatric TFTS should be based on clinical presentation, physical and radiological examinations, MRI, and pathologic changes in the filum. When such changes are accompanied with neurological signs, early severing of the filum is indicated regardless of conus position.
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Memo
1，上海交通大学医学院附属上海儿童医学中心神经外科（200127）；2，湖南省儿童医院外科（410007），E-mail: shbbx@online.sh.cn