View Full Version : Filum terminae

03-08-2010, 01:47 PM
Someone has heard before about that supposed cure of the scoliosis, Chiari and Siringomellia? http://www.institutchiaribcn.com/eng/index.htm
I have read in some forums and someone told it worked on them and others said that not and it is a fraud.

03-08-2010, 01:58 PM
I don't know how surgical section of the filum terminale effects ACM and/or syringomyelia, but it is NOT going to cure idiopathic scoliosis.

Complete sham.

03-08-2010, 05:46 PM
Someone has heard before about that supposed cure of the scoliosis, Chiari and Siringomellia? http://www.institutchiaribcn.com/eng/index.htm
I have read in some forums and someone told it worked on them and others said that not and it is a fraud.

That's an interesting find from the Neurologic Institute of Barcelona. I don't see where they use the word "cure" however. Appears this surgical method is a cutting of a ligament which is called the filum terminale. The procedure takes half an hour. Not too sure what to make of all this - hope Linda may swing this one past a few of the surgeons she knows, and give us their take on this. The testimonial they show doesn't really result in a huge reduction and requires further non surgical treatment to achieve further improvement (exercise and/or bracing, etc).

Some things noted on the website (click the link "scoliosis" in the middle of the page): http://www.institutchiaribcn.com/eng/infpacim.htm

Currently, and according to our published research studies, Scoliosis is a disease caused by the tethering of the spinal cord by a ligament called filum terminale which does not carry out any function in adults.

The first thing achieved by cutting the filum terminale is supressing the main strain that makes the disease progress. This way, when Scoliosis develops rapidly, the progression of the disease is greatly stoped.

In some cases, when the operation is carried out at an early stage, after cutting the filum terminale the vertebral column may spontaneously straighten up a few degrees, and some more if correct neurorehabilitation follows.

If the operation is carried out at an advanced stage of Scoliosis, in spite of the supression of the flexion-producing strain of the filum terminale, the vertebral unbalance itself becomes another flexion-producing strain that would require intense neurorehabilitation action, by means of a corset o surgery with a vertebral fixation system. In all cases, the section of the filum terminale is reccommended in order to improve the effect of any therapeutical actions taken and to minimize the aggression to the spinal cord when it is pulled by the action of corsets or the surgical correcting measures.

The strain of the filum terminale, besides forcing the spine to bend, in order to prevent the strain of the spinal cord, it also pulls downwards the lower part of the brain, the socalled cerebellar tonsils, into the foramen occipitalis which connects the skull to the spine, causing the Arnold Chiari Syndrome, a disease described 100 years ago and was of unknown cause up to present.

The surgical section of the filum for Arnold Chiari Syndrome makes the downward strain disappear for the cerebellar tonsils, it stops them from suffering because they do not opress themselves into the foramen occipitalis anymore. The operation improves many of the symptoms of the disease and the cerebellar tonsils do not move upwards because they are deformed and because of their little elasticity.

03-08-2010, 06:35 PM
Semantics. It won't stop progression either.

While I appreciate your regurgitation of what I already read on their site, THIS is the kind of stuff on there you should be paying attention to:

"Is this Scoliosis explanation any use to the patients?

Of course, with the simple section of this ligament the strain to which the spinal cord is subject stops, and then the flexion-producing stimuli stop being sent to the vertebral column so the progression of Scoliosis stops. "

Maxene, do you *really* believe if a little *snip-snip* was all it took to halt progression, they wouldn't be doing that here?

03-08-2010, 07:09 PM
Oh my gosh! I don't think I'm regurgitating, but it's nice to know that you would "appreciate" it if I were :D

I don't *believe* it's a cure for anything but rather perhaps a useful strategy in treatment. I find that interesting. The information does come from a reputable institution in Barcelona. And I am curious to know how our surgeons in the US would weigh in on this. Just wondering if this is being done in certain circumstances over here. Linda may know.

Pub Med reference: http://www.ncbi.nlm.nih.gov/pubmed/15723156

CONCLUSIONS: Section of the filum terminale is a useful strategy in the treatment of scoliosis, syringomyelia and the Chiari malformation, and offers a new aetiological basis for the understanding of these three disorders.

03-08-2010, 07:24 PM
That article is from 2005. Draw the necessary conclusions.

Also, it isn't clear if that is a peer-reviewed journal, or, if it is, if it is still stem to stem nonsense.

03-08-2010, 07:40 PM
Just wondering if this is being done in certain circumstances over here. Linda may know.

IF this surgery is being done, it's being done for tethered cord, and scoliosis *specifically* related to that.

This isn't a surgery that's done for plain old scoliosis.

You still don't seem to understand that all scoliosis isn't the same.

03-08-2010, 09:44 PM
I had my filum terminale sectioned (cut) in December '08 by Dr. Oro in Denver. I was having symptoms of occult tethered cord (losing balance, bladder symptoms, burning pain along my feet, etc., loss of bowel control--ALL SCARY STUFF). The surgery was a success, but I just had my back fused by Dr. Lenke in St. Louis on January 29 2010. At 37 years old there is no way I expected my scoliosis to be cured by the detethering.

That said. After consulting with Dr. Boachie (New York), Dr. Oro, and Dr. Lenke NONE of them said that the tethered cord caused my scoliosis. There is just no way to know yet. More research must be done. It might have been the cause--holding my stretching spine down while the rest of my body grew from age 9-15 while I wore my brace. Yet, no respected surgeon (in my opinion) would say more until more research is done.

When I was born in Mexico there was a hairy patch on the base of my back. Now days, perhaps, an alert doctor would suspect a mild form of spina bifida--and do an MRI. But no one can tell me for sure if they would have noticed anything on an MRI (it was occult--hidden--that's why none of the doctors here in Salt Lake would believe that I had the symptoms of occult tethered cord--they told me that I had peripheral neuropathy and prescribed Lyrica--I am young, thin and not diabetic and an RN who knows too much to believe that type of diagnosis).

Dr. Oro also told me I likely have Chiari type 0 -- this classification is also so new that many/most practitioners don't know if it is for "real" yet.

I would be extremely cautious of anyone saying that cutting the filum terminale would cure scoliosis.


03-08-2010, 10:32 PM
Thanks for weighing in, Jen.

ACM 0, huh? I follow the hydrocephalus boards (VP shunted since '79), and get a lot of "dribble down" stuff about ACM (when I have time to read it). I haven't seen that (only 1 and 2) - and obviously need to catch up!

Would you mind briefly explaining what distinguishes type 0?


03-08-2010, 10:53 PM
I get most of my info online. One site is http://www.ninds.nih.gov/disorders/chiari/detail_chiari.htm

Dr. Oro discussed that my cerebellum is right at the bottom of the foramen magnum--not protruding--but could be blocking the normal flow of CSF. I also have a possible syrinx. But, each practitioner I have seen has been very careful about calling it a true syrinx because it is so thin it could possibly be a persistent central canal from my fetal development.

It is frustrating having so many questions still not explained. But it is encouraging to me that some practitioners are at least interested in changing old beliefs and doing research. Maybe someday all the loose ends will make more sense. I made myself silly for a few days wondering how everything was linked--the possible Chiari, the syrinx, the scoliosis, the hairy patch on my lower back, and the occult tethered cord. Yet, in the end I had to tell myself that there is not enough evidence to prove anything YET.


03-09-2010, 11:34 PM
Hi Jennifer,

This is all in jest... you obviously didn't see a PEDIATRIC neurosurgeon or orthopedic surgeon in SLC about your fatty filum/TC issues. They know what that means. This is another example to me that we will continue seeing the pediatric docs and not switch to an adult specialist (I use that word lightly in this context) because they don't have the experience we need. Braydon is turning 15 this year (and yes, I have been MIA way too long!) so reading and catching up is important to me. Braydon has congenital scoliosis. He has had two TC/fatty filum release surgeries to date. Hopefully no more will be needed. He does not have any external "red flags" like a hairy patch, dimple, etc. We had to go by symptom only to have the first release surgery at age 4yrs old. Every experience is very different. I'm glad you have found the right answers for your situation.

03-10-2010, 12:34 AM
Carmell!!! :)

(... just sayin' ;-)

03-10-2010, 07:29 AM
I don't *believe* it's a cure for anything but rather perhaps a useful strategy in treatment.

What does this mean? I'm not being sarcastic but I don't get what a "useful strategy" is.

How can it be useful if it's not going to cure or help the problem??? Useful for what??

03-10-2010, 11:29 AM
I have read for people who said to have found a cure in this treatment, but I don’t know them, so I could not know if it really worked or not.
Logic says that if some treatment worked just only once, it should not be discarded.
If I create some original and never seen before scoliosis treatment based on my medical knowledge, all people who follow it and only it, would must to be saved by fusion in short or long time. Never could be found any case showing same type of improvement.
It could be so ingenuous to believe in a treatment if could not show any success, on the contrary would be illogic to discarded it.
Of course it could be difficult to be sure that in fact it worked just once, without a scientifically research.

03-12-2010, 10:16 AM
Of course it could be difficult to be sure that in fact it worked just once, without a scientifically research.

Sorely, resources seems to are being destined mainly (or only?) for improve the current and traditional surgery techniques or braces and not for other kind of solution, so we must to do that kind of research ourselves.
I think that a good sign of the effectiveness or not of some treatment is the credits of the professional or Institute guaranteeing it, but of course, it could not be enough.

09-16-2010, 02:04 PM

09-16-2010, 02:25 PM
Someone dope-slap me if I'm wrong but aren't these Chiari malformations and filum terminale issues only associated with a small percentage of scoliosis cases?

This thread is certainly on topic in a scoliosis forum because we definitely have parents and patients with this condition but I think it may not be clear that this is not relevant to the majority of IS cases which have not diagnosis of associated Chiari or FT issues.

Just hoping that is clear.

09-17-2010, 08:13 AM
It seems that at least in some cases, Chiari and Scoliosis has the same cause (Spinal traction). It seems that this kind of surgery woorks in those cases.
I donīt know if it is possible to measure the spinal traction. I think that only Ostheopats knows about it.

10-08-2010, 01:54 PM
x rays: http://www.institutchiaribcn.com/cast/infpacim.htm