This is the important scientific work published in 2013 in an international medical journal Japanese colleagues from the University of Hiroshima, for the first time, describing an instrumental technique, magnetic resonance imaging in the prone position, which identifies the location of the abnormal position of intradural filum terminale in patients with occult tethered cord syndrome.
The Japanese colleagues compared a group of patients with occult tethered cord syndrome with a group of asymptomatic persons. MRI in the prone position showed a significant difference in the position of the filum terminale between the two groups.
In patients with occult tethered cord syndrome the filum terminale not brought by gravity before with radicelle nervous but remained in the rear (see page of this site with the images of MRI in patients with occult tethered cord syndrome: "Occult tethered cord - MRI PRONE: IMAGES").
In patients with occult tethered cord syndrome the different position among radicelle nerve (cauda equina) of the filum terminale is interpreted as the difference in elasticity between these structures. A little elastic filum terminale can the risers bone to which it is connected causing disturbances that occur in the occult tethered cord syndrome.
This examination is part of the clinical protocol-adopted instrumental for our patients. This particular MRI allows the identification of patients who may benefit the surgical section of the filum terminale. If the filum terminale is not in tension it can not be the cause of patient symptoms. At present there are no other imaging studies that can give this kind of infomation. In this way it reduces the risk of placing surgical indications in patients with symptoms that, being generic and non-specific, may be due to other pathological situations.