McLendon R E, Oakes W J, Heinz E R, Yeates A E, Burger P C
Department of Pathology, Duke University Medical Center, Durham, North Carolina.
Neurosurgery. 1988 May;22(5):873-6.
Adipose tissue in the filum terminale is frequently associated with tethering of the spinal cord in patients with spina bifida occulta. We recently saw a patient with low back pain and no spina bifida occulta, in whom adipose tissue was noted in the area of the filum on an unenhanced computed tomographic (CT) scan. The patient had a tethered cord. This case suggested that, when CT scanning is done as the first imaging study in the evaluation of low back pain, fatty tissue in the area of the filum may be an indicator for tethering of the spinal cord. The present study was undertaken to determine the validity of using CT scan-detectable filal fat in the identification of possible tethered spinal cords among a group of patients experiencing low back pain. The presence of fat in the fila of 12 patients with the radiologically and histologically tethered cord syndrome was evaluated and the fila of 47 autopsied patients whose clinical history showed no back pain were examined histologically. There were accumulations of adipose tissue in the fila of 11 of the 12 (91%) patients with the tethered cord syndrome and in the fila of 9 of the 47 patients (17%) in the autopsy series. Of the 9 autopsy patients with fat in their fila, however only 3 patients (6%) exhibited collections of adipose tissue in the CT detection range (2 mm).(ABSTRACT TRUNCATED AT 250 WORDS)
隐性脊柱裂患者终丝中的脂肪组织常与脊髓栓系有关。我们最近接诊了一名无隐性脊柱裂但有腰痛的患者，其平扫计算机断层扫描（CT）显示终丝区域存在脂肪组织。该患者存在脊髓栓系。此病例提示，当CT扫描作为评估腰痛的首次影像学检查时，终丝区域的脂肪组织可能是脊髓栓系的一个指标。本研究旨在确定在一组腰痛患者中，利用CT扫描可检测到的终丝脂肪来识别可能存在的脊髓栓系的有效性。评估了12例经放射学和组织学诊断为脊髓栓系综合征患者终丝中脂肪的存在情况，并对47例尸检患者的终丝进行了组织学检查，这些尸检患者的临床病史显示无腰痛。在12例脊髓栓系综合征患者中，有11例（91%）的终丝存在脂肪堆积；在尸检系列的47例患者中，有9例（17%）的终丝存在脂肪堆积。然而，在9例终丝有脂肪的尸检患者中，只有3例（6%）在CT检测范围内（2毫米）显示有脂肪堆积。（摘要截选于250字）
