Tehli Ozkan, Hodaj Irgen, Kural Cahit, Solmaz Ilker, Onguru Onder, Izci Yusuf
Department of Neurosurgery, Gulhane Military Medical Academy, Etlik, Turkey.
Pediatr Neurosurg. 2011;47(6):412-6. doi: 10.1159/000338981. Epub 2012 Jul 7.
The structural changes in filum terminale (FT) may be responsible for tethered cord syndrome (TCS) in children. Although the histological changes in FT related to TCS are well-known, there is no comparative study of the changes which occur in TCS and normal fetal FT samples. The aims of this study are to compare the histological changes which occurred in FT samples of TCS and in fetuses, and to point out these changes.
During the last 2 years, 14 cases of TCS were operated on, the FT was cut and the spinal cord was released. Among them, 6 samples of FT were obtained for histopathological examination. Moreover, 1 FT from an adult cadaver and 4 samples from fetal FT were obtained for the same examination.
While adipose tissue, fibrosis, hyalinization, and meningothelial proliferation were observed in FT samples of TCS, none of these findings were observed in fetal samples. Elastic fibers were present in all TCS specimens and the adult cadaver, but were not observed in fetuses. Peripheral nerves, ganglion cells and ependymal cells were observed in fetal FT samples.
These changes probably begin at birth.
终丝（FT）的结构变化可能是儿童脊髓拴系综合征（TCS）的病因。尽管FT与TCS相关的组织学变化已为人熟知，但尚无关于TCS和正常胎儿FT样本中变化的比较研究。本研究的目的是比较TCS患者与胎儿FT样本中的组织学变化，并指出这些变化。
在过去2年中，对14例TCS患者进行了手术，切断FT并松解脊髓。其中，获取了6份FT样本进行组织病理学检查。此外，还获取了1份成人尸体的FT和4份胎儿FT样本进行相同检查。
在TCS的FT样本中观察到脂肪组织、纤维化、玻璃样变和脑膜内皮细胞增生，而在胎儿样本中未观察到这些发现。弹性纤维存在于所有TCS标本和成人尸体中，但在胎儿中未观察到。在胎儿FT样本中观察到周围神经、神经节细胞和室管膜细胞。
这些变化可能始于出生时。
