Hidden cause of paralysis: tight filum terminale in spinal cord injury without radiographic abnormality

This study looks at children who have spinal cord injuries that don't show up on X-rays or CT scans, called SCIWORA. The researchers analyzed data from four children with SCIWORA, focusing on how they were injured, what symptoms they had, and how they responded to surgery. The study suggests that a tight filum terminale (a structure at the end of the spinal cord) might be the hidden cause of some SCIWORA cases, and that surgery to release it could help.

• 1
  All four patients had thoracolumbar injuries with rapid progression of symptoms, including paralysis, sensory impairment, and urinary and fecal retention.
• 2
  Intraoperative findings in all four pediatric cases revealed spinal cord tethering, with evidence of fatty or fibrous degeneration involving the filum terminale.
• 3
  Three patients showed varying degrees of recovery in muscle strength and/or sensory function, as well as bladder and bowel function, while one showed no significant improvement.