Conventional criteria VS Filum System® method: The difference in surgical indications for Arnold-Chiari syndrome, syringomyelia, idiopathic scoliosis and other related diseases, based on the risk-benefit ratio of the surgical intervention

Published by ICSEB at 20 September, 2024

The Filum System^® is a unique method grounded in a scientific discovery, which was recognised in Dr. Royo-Salvador’s cum laude doctoral thesis by a committee of university professors. This discovery proves the existence of a new disease – the Filum Disease – as the underlying cause of various related conditions previously considered to be of unknown origin, including Arnold-Chiari Syndrome Types I, 0, and 1.5, syringomyelia and idiopathic scoliosis, among others.

In addition, the proposed treatment for these conditions employs a minimally invasive surgical technique, developed through original research, which reduces the risks associated with the traditional sectioning of the Filum terminale, both in terms of technique and anaesthesia (which is local).

Many patients with the mentioned diagnoses, who are recommended surgery by the ICSEB neurosurgeons, often wonder: why do other specialists recommend not performing surgery and instead suggest yearly check-ups without surgical intervention?

The answer depends on the interpretation of the disease, on what it is considered to be its cause, the treatment deemed appropriate to eliminate it, the method used and the goal of the surgery.

The factors that influence the balance between risks and benefits in a surgical intervention are: the patient preparation, pre-surgical stays, antibiotic prophylaxis, the level of surgical contamination, the duration and invasiveness of the procedure and the patient’s health condition. In addition to these factors, there are those related to anaesthesia and its type: general, local with sedation, or a combination of both.

When the chosen treatment is a major and invasive surgery – such as craniectomy for Arnold-Chiari Syndrome Type I and syringostomy for syringomyelia – it is typically recommended only for symptomatic cases, since these procedures can carry higher risks of morbidity and mortality than the natural course of the condition itself.

(See:

https://institutchiaribcn.com/en/diseases-we-treat/arnold-chiari-syndrome/

https://institutchiaribcn.com/en/diseases-we-treat/syringomyelia/ )

Conventionally, imaging and neurological follow-up is typically recommended for cases that do not have symptoms significantly affecting the patient’s quality of life.

On the other hand, if the chosen surgery is the Sectioning of the Filum Terminale for Filum Disease according to the Filum System®, its disadvantages are minimal, with only a few complications related to the surgical wound – such as infection or dehiscence – similar to any other surgery, with no neurological deficits, morbidity or mortality.

It is easy to see why, in most diagnosed cases, our neurosurgeons recommend undergoing the sectioning of the Filum Terminale as soon as possible: our method eliminates the root cause of the disease, stops its progression and allows the nervous system to repair any reversible lesion, preventing new ones from appearing or existing ones from becoming irreversible, thus improving the patient’s quality of life.

Since the benefits outweigh the risks, even for patients who are nearly asymptomatic or have no significant limitations, it is best to proceed without delay. This helps prevent the condition from worsening, which can happen with age, injuries, or other triggering factors, or simply due to the natural progression of the disease.

You can request a remote consultation with the ICSEB specialists for a second opinion, to see if you could be a candidate for the application of the Filum System® and potentially improve your quality of life!