SEM study on filum terminale with tethered cord syndrome

• Published in: Child's nervous system 2011-12, Vol.27 (12), p.2141-2144
• Main Authors: Liu, Fu-Yun, Li, Jian-Feng, Guan, Xia, Luo, Xiao-Fei, Wang, Zhi-Ling, Dang, Qiu-Hong
• Format: Article
• Language: English
• Subjects: Cauda Equina - pathology; Cauda Equina - ultrastructure; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Microscopy, Electron, Scanning - methods; Neural Tube Defects - pathology; Neurosciences; Neurosurgery; Original Paper
• ISSN: 0256-7040; 1433-0350
• DOI: 10.1007/s00381-011-1414-0

Objective To improve the understanding in pathology and provide steady proof for diagnosis and treatment of tethered cord syndrome (TCS), the ultrastructure of filum terminale (FT) with TCS will be researched, respectively. Methods Thirty-one fila were sectioned and divided into two groups according to diameter. Twenty-two fila thicker than 2 mm were placed into group 1; nine no thicker than 2 mm were placed into group 2. Their transverse and longitudinal sections were respectively submitted for scanning electron microscopy analysis. Results For the FTs with TCS, ultrastructural analysis confirmed the presence of abundant collagen bundles and adipocytes, sparse or invisible elastic and reticular fibers inside the FT, but the latter two fibers were still visible in the relative normal areas of FT; some abnormalities, such as thickening, distortion, adhesion or fusion to piece, relatively dense and disorderly arrangement at a different degree, were quite common for collagen fiber. Some areas looked blurry, and some crystallization appeared occasionally on their surface. For the FTs with TFTS, those changes as mentioned above were still exhibited, but slightly relatively. All the changes mentioned inside all the FTs may exist alone or concomitantly, rarely simultaneously. Moreover, they can be often seen focally or diffusely occasionally. Conclusions Low elasticity resulting from the destruction of the three-dimensional structure of FT is involved in TCS. Early FT severing is a treatment of choice no matter whether its appearance looks normal.