“The morphological analysis of the Filum Terminale and the description of the distal filum terminale externum.”
Article by Buloz-Osorio et al.

Published by ICSEB at 24 April, 2025

On 25th March 2025, the article “Morphological analysis of the filum terminale and detailed description of the distal filum terminale externum: a cadaveric study” by Buloz-Osorio E., Ortega-Sánchez M., Royo-Salvador M.B. and Rodríguez-Baeza A. was published in the journal Frontiers in Neuroanathomy.

This is an observational and anatomical description study, which we consider of great interest due to its relation to Filum Disease and Neuro-cranio-vertebral Syndrome, conditions that are treated with exceptional specialization at our Institut Chiari & Siringomielia & Escoliosis de Barcelona (ICSEB). These diseases are pathological expressions of the abnormal traction exerted precisely by the Filum terminale on the entire central nervous system, with repercussions both on the skull and the spine.

The Filum terminale (FT) “is a complex three-dimensional fibrocellular structure of connective tissue and glial cells, extending from the conus medullaris– the end of the spinal cord in the lumbar region – to the dural sac and the coccyx. It is divided into two segments: an intradural filum terminale internum and an extradural filum terminal externum.“

Currently, there is a debate among authors regarding intervention of the sectioning of the filum terminale. Some neurosurgeons still consider it to be less effective when performed on the externum FT rather than the FT internum; while others – as we do in our ICSEB team, through our minimally invasive technique – believe that it has the same effect of eliminating the caudal traction, achieving the desired goal with fewer complications and risks.

For this reason, as suggested in the concluding recommendations of the article by Buloz et al., it is important to continue research with “a more uniform approach, providing comparable morphological data for this complex structure. A deeper understanding of the filum terminale and its anatomical variations has the potential to significantly influence clinical practices and surgical techniques, particularly in Neurosurgery and spinal interventions.”

We thank Buloz and Ortega-Sánchez, in collaboration with our professionals – the Director of ICSEB and Founding Patron of the Chiari & Scoliosis & Syringomyelia Foundation, Dr. M. B. Royo Salvador, and Patron Prof. Dr. A. Rodríguez-Baeza – for their constant dedication in this regard, and we hope others continue to explore in this same direction.

If you wish to read the article, you can find it at:

https://institutchiaribcn.com/morphological-analysis-of-the-filum-terminale-and-detailed-description-of-the-distal-filum-terminale-externum-a-cadaveric-study/