NEUROCIRUGA

KENNETH LOPEZ GUTIERREZ

MEDICO RESIDENTE II HOSPITAL GUILLERMO ALMENARA IRIGOYEN

INTRODUCCION
Fuchs in 1910, who noted incontinence upon flexion in patients with MMC and inferred that this symptom was a result of tension on the spinal cord. Lichtenstein in 1940. Garceau in 1953 coined the term filum terminale Syndrome Hoffman et al in 1976: tethered spinal cord . El Filum terminale es una banda fibrosa con dos segmentos: intradural y extradural. Se extiende desde el cono medular hasta el coxis. Empieza a formarse en 8 sem. Entre la 8 y 25 sem. Hay un relativo ascenso. Al nacer se ubica entre T12-L2. Presentacin clnica. Traccin medular cambios metablicos y anatmicos. Criterios radiolgicos

ANATOMIC STUDY OF THE FILUM TERMINALE AND ITS CORRELATIONS WITH THE TETHERED CORD SYNDROME. Neurosurgery 51:725-730, 2002

OBJETIVO

Describir los hallazgos anatmicos intradurales del FT: longitud, dimetro, nivel vertebral de origen e insercin.

ANATOMIC STUDY OF THE FILUM TERMINALE AND ITS CORRELATIONS WITH THE TETHERED CORD SYNDROME. Neurosurgery 51:725-730, 2002

MATERIAL Y METODOS

41 cadveres fueron estudiados entre 4 y 8 hs despus de muertos. 33 varones y 8 mujeres. Edad promedio: 53.9 aos Peso promedio: 68.3 kg Talla promedio: 166.4 cm Historia negativa de enfermedad espinal.

ANATOMIC STUDY OF THE FILUM TERMINALE AND ITS CORRELATIONS WITH THE TETHERED CORD SYNDROME. Neurosurgery 51:725-730, 2002

MATERIAL Y METODOS
Laminectoma de T11 a S3. Apertura de duramadre e identificacin de FT. Dividieron las vrtebras en tercios: superior, medio e inferior. Medicin de longitud y dimetro.

ANATOMIC STUDY OF THE FILUM TERMINALE AND ITS CORRELATIONS WITH THE TETHERED CORD SYNDROME. Neurosurgery 51:725-730, 2002

RESULTADOS
Inicio del FT:
1 (2.4%) en tercio inferior de T11 3 (7.3%) en tercio superior de T12 2 (4.8%) en tercio inferior de T12 3 (7.3%) en espacio T12-L1 2 (4.8%) en tercio superior de L1 8 (19.5%) en tercio medio de L1 7 (17.1%) en tercio inferior de L1

ANATOMIC STUDY OF THE FILUM TERMINALE AND ITS CORRELATIONS WITH THE TETHERED CORD SYNDROME. Neurosurgery 51:725-730, 2002

RESULTADOS

5 (12.2%) en espacio L1-L2 2 (4.8%) en tercio superior de L2

3 (7.32%) en tercio medio de L2

3 (7.32%) en tercio inferior de L2 2 (4.88%) en espacio L2L3

ANATOMIC STUDY OF THE FILUM TERMINALE AND ITS CORRELATIONS WITH THE TETHERED CORD SYNDROME. Neurosurgery 51:725-730, 2002

RESULTADOS

ANATOMIC STUDY OF THE FILUM TERMINALE AND ITS CORRELATIONS WITH THE TETHERED CORD SYNDROME. Neurosurgery 51:725-730, 2002

RESULTADOS
Fusin del FT:
3 (7.32%) en tercio superior de S1 1 (2.44%) en tercio medio de S1

5 (12.20%) en tercio inferior de S1

3 (7.32%) en espacio S1S2 13 (31.71%) en tercio superior de S2

3 (7.32%) en tercio medio de S2

3 (7.32%) en tercio inferior de S2

ANATOMIC STUDY OF THE FILUM TERMINALE AND ITS CORRELATIONS WITH THE TETHERED CORD SYNDROME. Neurosurgery 51:725-730, 2002

RESULTADOS

4 (9.76%) en espacio S2S3

2 (4.88%) en tercio superior de S3 3 (7.32%) en tercio medio de S3

1 (2.44%) en tercio inferior de S3

ANATOMIC STUDY OF THE FILUM TERMINALE AND ITS CORRELATIONS WITH THE TETHERED CORD SYNDROME. Neurosurgery 51:725-730, 2002

RESULTADOS

ANATOMIC STUDY OF THE FILUM TERMINALE AND ITS CORRELATIONS WITH THE TETHERED CORD SYNDROME. Neurosurgery 51:725-730, 2002

RESULTADOS

ANATOMIC STUDY OF THE FILUM TERMINALE AND ITS CORRELATIONS WITH THE TETHERED CORD SYNDROME. Neurosurgery 51:725-730, 2002

LONG-TERM OUTCOME OF TOTAL AND NEAR-TOTAL RESECTION OF SPINAL CORD LIPOMAS AND RADICAL RECONSTRUCTION OF THE NEURAL PLACODE: PART ISURGICAL TECHNIQUE. Neurosurgery 65:511529, 2009

LONG-TERM OUTCOME OF TOTAL AND NEAR-TOTAL RESECTION OF SPINAL CORD LIPOMAS AND RADICAL RECONSTRUCTION OF THE NEURAL PLACODE: PART ISURGICAL TECHNIQUE. Neurosurgery 65:511529, 2009

LONG-TERM OUTCOME OF TOTAL AND NEAR-TOTAL RESECTION OF SPINAL CORD LIPOMAS AND RADICAL RECONSTRUCTION OF THE NEURAL PLACODE: PART ISURGICAL TECHNIQUE. Neurosurgery 65:511529, 2009

LONG-TERM OUTCOME OF TOTAL AND NEAR-TOTAL RESECTION OF SPINAL CORD LIPOMAS AND RADICAL RECONSTRUCTION OF THE NEURAL PLACODE: PART ISURGICAL TECHNIQUE. Neurosurgery 65:511529, 2009

ANATOMIC STUDY OF THE FILUM TERMINALE AND ITS CORRELATIONS WITH THE TETHERED CORD SYNDROME. Neurosurgery 51:725-730, 2002

ANATOMIC STUDY OF THE FILUM TERMINALE AND ITS CORRELATIONS WITH THE TETHERED CORD SYNDROME. Neurosurgery 51:725-730, 2002

LONG-TERM OUTCOME OF TOTAL AND NEAR-TOTAL RESECTION OF SPINAL CORD LIPOMAS AND RADICAL RECONSTRUCTION OF THE NEURAL PLACODE: PART ISURGICAL TECHNIQUE. Neurosurgery 65:511529, 2009