{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T07:22:22Z","timestamp":1773559342867,"version":"3.50.1"},"reference-count":32,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2012,1]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The filum terminale (FT) is considered a fibrous structure that extends from conus medullaris of the spinal cord to coccyx. Based on previous studies and from their own experience with intraoperative electrophysiological monitoring of the sacral nervous system, the authors postulate that the FT contains functional neural elements in some individuals.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The FT was dissected from 13 fresh stillborn cadavers (7 male, 6 female; mean gestational age 36 weeks and 1 day). The gross anatomical features were recorded, and connections between the FT and the nerve roots of the cauda equina were noted. These connections, when present, were sectioned for histological studies. The fila (both interna and externa) were also sectioned for histological and immunohistochemical studies. In addition, FT specimens were obtained from 5 patients undergoing sectioning of the FT in an untethering surgical procedure.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>There were 5 gross connections between the FT and nerve roots demonstrating nerve fibers that were positive for S100. The FT showed islands of cells that were positive for GFAP in 10 cases, synaptophysin in 3 cases, S100 in 11 cases, and nestin in 2 cases. The nerve fibers in the FT were myelinated in 2 cases. The conus ended at the L-1 or L-2 vertebral level in all 13 specimens. The dural sac terminated at the S-2 vertebral level in most of the specimens. The 5 FT specimens that were obtained from patients revealed nerve bundles that were positive for S100 in 4 cases and cells that were positive for GFAP in 3 cases.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>There are gross anatomical connections between the FT and nerve roots that contain nerve fibers. Apart from fibrous stroma, the FT may contain nerve bundles and cells that stain positive for GFAP, synaptophysin, S100, and nestin. These microscopic findings and previous intraoperative electrophysiological studies suggest a probable functional role for the FT in some individuals. At birth, the conus ends at a higher vertebral level (lower L-1 or upper L-2) than L-3.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2011.10.peds11102","type":"journal-article","created":{"date-parts":[[2011,12,30]],"date-time":"2011-12-30T17:13:01Z","timestamp":1325265181000},"page":"86-92","source":"Crossref","is-referenced-by-count":24,"title":["Gross and microscopic study of the filum terminale: does the filum contain functional neural elements?"],"prefix":"10.3171","volume":"9","author":[{"given":"Samson Sujit Kumar","family":"Gaddam","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vissa","family":"Santhi","sequence":"additional","affiliation":[{"name":"Pathology, Narayana Medical College, Nellore; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Srinivasa","family":"Babu","sequence":"additional","affiliation":[{"name":"Sections of Neurophysiology,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geeta","family":"Chacko","sequence":"additional","affiliation":[{"name":"Neuropathology, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramakrishna Appala","family":"Baddukonda","sequence":"additional","affiliation":[{"name":"Pathology, Narayana Medical College, Nellore; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vedantam","family":"Rajshekhar","sequence":"additional","affiliation":[{"name":"Neurosurgery, Department of Neurological Sciences, Christian Medical College, Vellore, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-0090086","series-title":"Muscle Nerve","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1002\/mus.880150507","article-title":"Median\u2013ulnar nerve communications and anomalous innervation of the intrinsic hand muscles: an electrophysiological study","volume":"15","author":"Amoiridis","year":"1992"},{"key":"b2-0090086","series-title":"J Anat","first-page":"489","article-title":"The vertebral level of termination of the spinal cord during normal and abnormal development","volume":"106","author":"Barson","year":"1970"},{"key":"b3-0090086","series-title":"Grays Anatomy: The Anatomical basis of Medicine and Surgery","first-page":"901","article-title":"Nervous system","author":"Berry","year":"1995"},{"key":"b4-0090086","series-title":"Neurosurg Rev","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1007\/s101430050049","article-title":"Ulnar to median nerve anastomosis in the palm (Riches-Cannieu anastomosis)","volume":"22","author":"B\u00f6l\u00fckba\u015fi","year":"1999"},{"key":"b5-0090086","series-title":"Hum Pathol","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1016\/0046-8177(92)90405-R","article-title":"The ventriculus terminalis and filum terminale of the human spinal cord","volume":"23","author":"Choi","year":"1992"},{"key":"b6-0090086","series-title":"Neurosci Res","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/S0168-0102(01)00211-5","article-title":"Membrane currents and morphological properties of neurons and glial cells in the spinal cord and filum terminale of the frog","volume":"40","author":"Chv\u00e1tal","year":"2001"},{"key":"b7-0090086","series-title":"Neuroembryology","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1159\/000071020","article-title":"The immunohistochemical profile of the normal conus medullaris and filum terminale","volume":"2","author":"Cummings","year":"2003"},{"key":"b8-0090086","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"978","DOI":"10.1227\/01.NEU.0000210224.54816.40","article-title":"Ultrastructural study of the filum terminale and its elastic fibers","volume":"58","author":"Fontes","year":"2006"},{"key":"b9-0090086","series-title":"J Anat","first-page":"173","article-title":"Electron microscope observations upon the conus medullaris and filum terminale of human fetuses","volume":"110","author":"Gamble","year":"1971"},{"key":"b10-0090086","series-title":"Brain Res","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1016\/0006-8993(79)90537-7","article-title":"The filum terminale of the frog spinal cord, a non transformed preparation: I. 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