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Fatty filum terminale. mri. The lumbar canal and conus appear normal, with the tip of the conus located at the L1 level. Immediately below the conus, in the midline is a longitudinal streak of high T1 and high T2 signal tissue with attenuates following fat saturation and demonstrates no enhancement.
Lipoma of the filum terminale, also known as fatty filum terminale or filar lipoma, is a relatively common finding on imaging of the lumbar spine, and in most cases is an incidental finding of no clinical concern.
In less severe forms, like spina bifida occulta, other congenital anomalies such as fatty tissue (lipoma) or a thickened band (thickened filum) at the end of their spinal cord can cause it to attach abnormally to the canal wall.
Due to its high viscoelasticity, the filum allows movement of the spinal cord. If abnormal fibrous tissue grows into the filum and replaces glial tissue, the filum loses its elasticity and abnormally fixes (tethers) the spinal cord, and becomes the mechanical cause of tethered cord syndrome.
A tethered spinal cord occurs when the spinal cord is attached to tissue around the spine, most commonly at the base of the spine. As a result, the spinal cord can’t move freely within the spinal canal.
The article discusses lipoma of the filum terminale, a rare benign tumor in the spinal cord.
This study reviewed the clinical, radiological, and pathological features of the filum terminale in patients who underwent transection of the filum suspected with tethered cord syndrome. The relation between the conus level, syrinx, clinical characteristics, and pathological features was evaluated.