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Tight Filum Terminale

Tight Filum Terminale Abstract Few congenital anomalies of the nervous system are amenable to surgical intervention. In a small number of cases such anatomic malformations are compatible with normal or near normal function until changes in growth produce locomotive or sphincteric disturbances or both. A review of the records of 442 patients with spina bifida occulta seen at the Mayo Clinic in the past decade disclosed six (Cases 1 to 6) with tight filum terminale. Historical Aspects Tulpuis in 1641 was the first to use the term "spina bifida." Mention of such anomalies is found, however, as early as the writings of Hippocrates.* Since then the ebb and flow of thought on this most perplexing of biologic phenomena is wondrous, but very little concerns the anchoring filum terminale.Fuchs † coined the word "myelodysplasia" to explain the relationship of spina bifida, enuresis, and deformities of the feet. De Vries3 suggested the use of References 1. Cited by Fisher, R. G.1 2. Fuchs,2 and Fuchs and Mattauschek, cited by de Vries.3 3. Riley, H. A., in discussion on Parker and McConnell,7 p. 16. 4. References 9 through 15. 5. Fisher, R. G.: Spina Bifida and Cranium Bifidum: A Clinico-Pathological Study, Thesis, University of Minnesota Graduate School, 1950. 6. Fuchs, A.: Über Beziehungen der Enuresis nocturna zu Rudimentärformen der Spina bifida occulta (Myelodysplasie) , Wien. med. Wchnschr. 60:1569-1573, 1910. 7. de Vries, E.: Spina Bifida Occulta and Myelodysplasia with Unilateral Clubfoot Beginning in Adult Life , Am. J. M. Sc. 175:365-371, 1928.Crossref 8. Lichtenstein, B. W.: "Spinal Dysraphism": Spina Bifida and Myelodysplasia , Arch. Neurol. & Psychiat. 44:792-809 ( (Oct.) ) 1940. 9. Woltman, H. W.: Spina Bifida , Minnesota Med. 4:244-248 ( (April) ) 1921. 10. Lichtenstein, B. W.: Distant Neuroanatomic Complications of Spina Bifida (Spinal Dysraphism): Hydrocephalus, Arnold-Chiari Deformity, Stenosis of Aqueduct of Sylvius, etc.; Pathogenesis and Pathology , Arch. Neurol. & Psychiat. 47:195-214 ( (Feb.) ) 1942. 11. Parker, H. L., and McConnell, A. A.: Internal Hydrocephalus: Resulting from Peculiar Deformity of Hind-Brain , Tr. Am. Neurol. A. 63:14-15, 1937. 12. Garceau, G. J.: Filum Terminale Syndrome (Cord-Traction Syndrome) , J. Bone & Joint Surg. 35-A: 711-716 ( (July) ) 1953. 13. Brickner, W. M.: Spina Bifida Occulta: (1) With External Signs With Symptoms; (2) With External Signs, Without Symptoms; (3) Without External Signs, With Symptoms; (4) Without Signs, Without Symptoms , Am. J. M. Sc. 155:473-502 ( (April) ) 1918. 14. Jones: Spina Bifida Occulta: No Paralytic Symptoms Until 17 Years of Age: Spine Trephined to Relieve Pressure on the Cauda Equina: Recovery , Brit. M. J. 1:173-174 ( (Jan. 24) ) 1891. 15. McKenzie, K. G., and Dewar, F. P.: Scoliosis with Paraplegia , J. Bone & Joint Surg. 31-B:162-174 ( (May) ) 1949. 16. Reimann, A. F., and Anson, B. J.: Vertebral Level of Termination of the Spinal Cord with Report of a Case of Sacral Cord , Anat. Rec. 88:127-138 ( (Jan.) ) 1944. 17. Robertson, A. A.: Spina Bifida Occulta with Spinal Cord Lesion , M. Clin. North America 7:1855-1866 ( (May) ) 1924. 18. Sarpyener, M. A.: Spina Bifida Aperta and Congenital Stricture of the Spinal Canal , J. Bone & Joint Surg. 29:817-821 ( (July) ) 1947. 19. Sharpe, N.: Spina Bifida: An Experimental and Clinical Study , Ann. Surg. 61:151-165 ( (Feb.) ) 1915. 20. Streeter, G. L.: Factors Involved in the Formation of the Filum Terminale , Am. J. Anat. 25:1-11 ( (Jan.) ) 1919. 21. Kunitomo, K.: Development and Reduction of the Tail and of the Caudal End of the Spinal Cord , in Contributions to Embryology , Washington, D. C., Carnegie Institution of Washington, 1918, Vol. 8, pp. 161-198. 22. Kernohan, J. W.: Ventriculus Terminalis: Its Growth and Development , J. Comp. Neurol. 38:107-125 ( (Dec.) ) 1924. 23. Harmeier, J. W.: Normal Histology of the Intradural Filum Terminale, Thesis, University of Minnesota, Graduate School, 1932. 24. Ingraham, F. D., and Lowry, J. J.: Spina Bifida and Cranium Bifidum: Occult Spinal Disorders , New England J. Med. 228:745-750 ( (June 10) ) 1943. 25. Peritz, G.: Enuresis nocturna und Spina bifida occulta , München. med. Wchnschr. 58:714-715 ( (March) ) 1911. 26. Spiller, W. G.: Congenital and Acquired Enuresis from Spinal Lesion: (a) Myelodysplasia, (b) Stretching of the Cauda Equina , Am. J. M. Sc. 151:469-475 ( (April) ) 1916. 27. Meredith, J. M.: Unusual Congenital Anomalies of the Lumbo-Sacral Spine (Spina Bifida): With a Report of 3 Cases , J. Nerv. & Ment. Dis. 99:115-133 ( (Feb.) ) 1944. 28. Hintze, A.: Enuresis nocturna, Spina bifida occulta und epidurale Injektion , Mitt. Grenzgeb. Med. u. Chir. 35:484-543, 1922. 29. Boettcher, T.: Die Prognose der Operation der Spina bifida , Beitr. klin. Chir. 53:519-565, 1907. 30. Katzenstein, M.: Beitrag zur Pathologie und Therapie der Spina bifida occulta , Arch. klin. Chir. 64:607-629, 1901. 31. Eaton, L. M.: Pain Caused by Disease Involving Sensory Nerve Roots (Root Pain): Its Characteristics and the Mechanics of Its Production , J.A.M.A. 117:1435-1439 ( (Oct. 25) ) 1941.Crossref 32. Grant, J. C. B.: Method of Anatomy Descriptive and Deductive , Ed. 2, Baltimore, Williams & Wilkins Company, 1942, pp. 17-18. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1956 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1956.01280040010002
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Abstract

Abstract Few congenital anomalies of the nervous system are amenable to surgical intervention. In a small number of cases such anatomic malformations are compatible with normal or near normal function until changes in growth produce locomotive or sphincteric disturbances or both. A review of the records of 442 patients with spina bifida occulta seen at the Mayo Clinic in the past decade disclosed six (Cases 1 to 6) with tight filum terminale. Historical Aspects Tulpuis in 1641 was the first to use the term "spina bifida." Mention of such anomalies is found, however, as early as the writings of Hippocrates.* Since then the ebb and flow of thought on this most perplexing of biologic phenomena is wondrous, but very little concerns the anchoring filum terminale.Fuchs † coined the word "myelodysplasia" to explain the relationship of spina bifida, enuresis, and deformities of the feet. De Vries3 suggested the use of References 1. Cited by Fisher, R. G.1 2. Fuchs,2 and Fuchs and Mattauschek, cited by de Vries.3 3. Riley, H. A., in discussion on Parker and McConnell,7 p. 16. 4. References 9 through 15. 5. Fisher, R. G.: Spina Bifida and Cranium Bifidum: A Clinico-Pathological Study, Thesis, University of Minnesota Graduate School, 1950. 6. Fuchs, A.: Über Beziehungen der Enuresis nocturna zu Rudimentärformen der Spina bifida occulta (Myelodysplasie) , Wien. med. Wchnschr. 60:1569-1573, 1910. 7. de Vries, E.: Spina Bifida Occulta and Myelodysplasia with Unilateral Clubfoot Beginning in Adult Life , Am. J. M. Sc. 175:365-371, 1928.Crossref 8. Lichtenstein, B. W.: "Spinal Dysraphism": Spina Bifida and Myelodysplasia , Arch. Neurol. & Psychiat. 44:792-809 ( (Oct.) ) 1940. 9. Woltman, H. W.: Spina Bifida , Minnesota Med. 4:244-248 ( (April) ) 1921. 10. Lichtenstein, B. W.: Distant Neuroanatomic Complications of Spina Bifida (Spinal Dysraphism): Hydrocephalus, Arnold-Chiari Deformity, Stenosis of Aqueduct of Sylvius, etc.; Pathogenesis and Pathology , Arch. Neurol. & Psychiat. 47:195-214 ( (Feb.) ) 1942. 11. Parker, H. L., and McConnell, A. A.: Internal Hydrocephalus: Resulting from Peculiar Deformity of Hind-Brain , Tr. Am. Neurol. A. 63:14-15, 1937. 12. Garceau, G. J.: Filum Terminale Syndrome (Cord-Traction Syndrome) , J. Bone & Joint Surg. 35-A: 711-716 ( (July) ) 1953. 13. Brickner, W. M.: Spina Bifida Occulta: (1) With External Signs With Symptoms; (2) With External Signs, Without Symptoms; (3) Without External Signs, With Symptoms; (4) Without Signs, Without Symptoms , Am. J. M. Sc. 155:473-502 ( (April) ) 1918. 14. Jones: Spina Bifida Occulta: No Paralytic Symptoms Until 17 Years of Age: Spine Trephined to Relieve Pressure on the Cauda Equina: Recovery , Brit. M. J. 1:173-174 ( (Jan. 24) ) 1891. 15. McKenzie, K. G., and Dewar, F. P.: Scoliosis with Paraplegia , J. Bone & Joint Surg. 31-B:162-174 ( (May) ) 1949. 16. Reimann, A. F., and Anson, B. J.: Vertebral Level of Termination of the Spinal Cord with Report of a Case of Sacral Cord , Anat. Rec. 88:127-138 ( (Jan.) ) 1944. 17. Robertson, A. A.: Spina Bifida Occulta with Spinal Cord Lesion , M. Clin. North America 7:1855-1866 ( (May) ) 1924. 18. Sarpyener, M. A.: Spina Bifida Aperta and Congenital Stricture of the Spinal Canal , J. Bone & Joint Surg. 29:817-821 ( (July) ) 1947. 19. Sharpe, N.: Spina Bifida: An Experimental and Clinical Study , Ann. Surg. 61:151-165 ( (Feb.) ) 1915. 20. Streeter, G. L.: Factors Involved in the Formation of the Filum Terminale , Am. J. Anat. 25:1-11 ( (Jan.) ) 1919. 21. Kunitomo, K.: Development and Reduction of the Tail and of the Caudal End of the Spinal Cord , in Contributions to Embryology , Washington, D. C., Carnegie Institution of Washington, 1918, Vol. 8, pp. 161-198. 22. Kernohan, J. W.: Ventriculus Terminalis: Its Growth and Development , J. Comp. Neurol. 38:107-125 ( (Dec.) ) 1924. 23. Harmeier, J. W.: Normal Histology of the Intradural Filum Terminale, Thesis, University of Minnesota, Graduate School, 1932. 24. Ingraham, F. D., and Lowry, J. J.: Spina Bifida and Cranium Bifidum: Occult Spinal Disorders , New England J. Med. 228:745-750 ( (June 10) ) 1943. 25. Peritz, G.: Enuresis nocturna und Spina bifida occulta , München. med. Wchnschr. 58:714-715 ( (March) ) 1911. 26. Spiller, W. G.: Congenital and Acquired Enuresis from Spinal Lesion: (a) Myelodysplasia, (b) Stretching of the Cauda Equina , Am. J. M. Sc. 151:469-475 ( (April) ) 1916. 27. Meredith, J. M.: Unusual Congenital Anomalies of the Lumbo-Sacral Spine (Spina Bifida): With a Report of 3 Cases , J. Nerv. & Ment. Dis. 99:115-133 ( (Feb.) ) 1944. 28. Hintze, A.: Enuresis nocturna, Spina bifida occulta und epidurale Injektion , Mitt. Grenzgeb. Med. u. Chir. 35:484-543, 1922. 29. Boettcher, T.: Die Prognose der Operation der Spina bifida , Beitr. klin. Chir. 53:519-565, 1907. 30. Katzenstein, M.: Beitrag zur Pathologie und Therapie der Spina bifida occulta , Arch. klin. Chir. 64:607-629, 1901. 31. Eaton, L. M.: Pain Caused by Disease Involving Sensory Nerve Roots (Root Pain): Its Characteristics and the Mechanics of Its Production , J.A.M.A. 117:1435-1439 ( (Oct. 25) ) 1941.Crossref 32. Grant, J. C. B.: Method of Anatomy Descriptive and Deductive , Ed. 2, Baltimore, Williams & Wilkins Company, 1942, pp. 17-18.

Journal

A.M.A. Archives SurgeryAmerican Medical Association

Published: Oct 1, 1956

References