Spina Bifida and Tethered Spinal Cord Specialty Clinic（番禺院区）

Filum terminale-type tethered cord syndrome is a common neural tube developmental defect in pediatric neurosurgery. It is a neurological damage syndrome caused by oxidative metabolic injury of the spinal cord and nerves resulting from traction of the spinal cord by poorly elastic filum terminale tissue, and presenting mainly with neurogenic bowel (intractable constipation, abdominal pain, fecal leakage), neurogenic bladder (enuresis, urine leakage, urinary frequency, recurrent urinary tract infection), low back and leg pain, unsteady gait, and clubfoot. 1. Diagnostic basis for filum terminale-type tethered cord: a clinical diagnosis reached by comprehensively considering the clinical manifestations, radiological imaging, and various functional examinations (neuroelectrophysiology, urinary system ultrasound, urodynamic study, anorectal manometry, lower limb electromyography); there is no definitive diagnostic criterion in imaging. 2. Surgical indications: a. presence of a typical neurological damage syndrome; b. magnetic resonance imaging showing thickening of the filum terminale or an obvious fat signal on the T1 axial section; c. if supine magnetic resonance imaging shows no positive finding, the child may undergo an additional prone MRI examination; d. negative magnetic resonance imaging — examine whether there is any abnormality in the sacrococcygeal region on physical examination, and combine this with positive findings on functional examinations. 3. Whether symptoms can be relieved after surgery: clinical observations by physicians at home and abroad on children with filum terminale-type tethered cord have found that the relief rates of typical symptoms of tethered cord after filum terminale sectioning were 84.2% and 78.3%. Moreover, receiving surgery as early as possible is the only means to avoid continuous neurological functional impairment. 4. Is filum terminale sectioning a minimally invasive procedure? Simple filum terminale sectioning can be performed in a minimally invasive manner. We currently adopt the internationally popular interlaminar approach to section the filum terminale and complete tethered cord release.