Investigation of Surgical Sectioning of the Filum Terminale in Treating Occult Tethered Cord Syndrome Patients

Launched by WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY · Dec 9, 2021

Keywords

ClinConnect Summary

This clinical trial is exploring a surgical procedure aimed at helping patients with Occult Tethered Cord Syndrome (OTCS). This condition involves a specific problem with the spinal cord that can cause various symptoms like pain and problems with movement. The researchers believe that surgically cutting a fibrous strand at the end of the spinal cord, called the filum terminale, may provide better relief from these symptoms compared to just using medications. They want to find out if the benefits of this surgery outweigh any potential risks for the patients involved.

To participate in this study, individuals should be between the ages of 2 and 80 and have not found relief from their symptoms through medical treatment for at least a year. Additionally, they must have a confirmed diagnosis of OTCS based on specific scoring criteria. The trial is currently recruiting participants and aims to provide insights into whether this surgical approach could be a more effective option for managing OTCS. Participants will have the opportunity to receive the surgery and be monitored for their recovery and symptom improvement.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Male or female ≥ 2 and \< 80 years of age.
• • Refractory to medical management of symptoms for at least 1 year.
• * Documentation of OTCS, as defined by a total score of at least 30 on the following scale:
• • OCCULT Grading Scale (Score 0-100) Orthopedic Abnormality: 0-15; Central Nervous System Dysfunction: 0-25; Cutaneous Stigmata: 0-10; Urological or Bowel Dysfunction: 0-25; Lumbosacral Anatomy: 0-15; Tissue Integrity Disorder: 0-10.
• Exclusion Criteria:
• • Subjects \< 2 or \> 80 years of age.
• * Radiographically identified tethered cord, as defined by any of the following:
• • A low-lying conus (at or below the L2-3 disc space)
• • A thickened filum (\>2 mm)
• • Fat in the filum or lipoma
• • Distinct adhesion or tethering.
• • A history of Meningocele manqué or Myelomeningocele.
• • Cutaneous markings of dermal sinus tract.
• • History of prior surgery on the lumbar spine.
• • History of prior surgery for spinal dysraphism.
• • History of prior infection or autoimmune condition of the central nervous system.