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- Department of Neurosciences -
Simple Interdepartmental Structure (SSI)
of Peripheral Nervous System Surgery
- AUSL of Romagna -
Historic Hospital "For the Sick" of Faenza (RA) Viale Stradone 9
(Photo: Hall of Columns)
Neurosurgical treatments with Dr. Veronesi Vanni
Specializations and Services Offered
Dr. Veronesi Vanni specializes in advanced treatments for various neurosurgical conditions.
Particular attention is dedicated to TETHERED CORD SYNDROME and OCCULT TETHERED CORD.
The FILUM TERMINALE is a thin filament made up of fibrovascular tissue that connects the end of the SPINAL CORD to the COCCYX. This elastic structure acts as a shock absorber during movements of the spine.
The alteration of the elasticity of the FILUM TERMINALE can lead to what can be defined as "FILUM DISEASE" and cause symptoms associated with traction of the SPINAL CORD present in TETHERED CORD SYNDROME and OCCULT TETHERED CORD.
These alterations are rare and require careful evaluation and personalized treatment.
Dr. Veronesi offers his 15 years of experience in this field to improve the quality of life of patients affected by the aforementioned syndromes.
Pathologies associated with TETHERED CORD SYNDROME and OCCULT TETHERED CORD:
· Chiari Malformations
· Ehlers-Danlos Syndrome
· Cranio-cervical instability
Contacts
Dr. Veronesi is available for consultations at the "Per gli Infermi" Hospital in Faenza, AUSL della Romagna. To make an appointment, call 800 00 44 88. Further information is available within this website.
OCCULT TETHERED CORD SYNDROME:
an underrecognized disease that is difficult to diagnose.
A 2020 study compared the information contained in the five data sources that represent the most authoritative voices on rare diseases:
ORPHANET (online database of rare diseases and orphan drugs),
OMIM (Online Mendelian Inheritance in Man),
GARD (Genetic and Rare Disease Information Center),
DOID (Disease Ontology),
NCI Thesaurus (National Cancer Institute Thesaurus) (Haendel et al, Nature Review DrugDiscovery, 2020;19:77-78).
Given that 6,370 diseases are present in at least three of the aforementioned databases, 4,023 diseases are present only in individual databases. Combining this information, a total number of 10,393 rare diseases emerges, a number that other studies suggest may even be underestimated (Bamshad et al, Am J Hum Genet, 2019;105:448-355; Smith et al, iScience 2022;25:104698).
TETHERED CORD SYNDROME is present in the databases ORPHANET, GARD, and NCI Thesaurus.
This pathology is supported in clinical diagnosis by standard lumbar MRI.
OCCULT TETHERED CORD SYNDROME IS NOT PRESENT IN THE ABOVE-MENTIONED RARE DISEASE DATABASES.
In occult tethered cord syndrome, the standard lumbar MRI is normal and the support for clinical diagnosis, based on symptoms and the result of the medical examination which also includes specific tests, is a particular lumbar MRI in the prone position.
The lumbar MRI in the prone position has been studied in OCCULT TETHERED CORD SYNDROME in only two scientific works, one by Japanese colleagues from Hiroshima University (Use of prone position magnetic resonance imaging for detecting the terminal filum in patients with occult tethered cord syndrome. J Neurosurg Spine 18:76–84, 2013 ©AANS, 2013) and one of mine (Prone Position Magnetic Resonance Imaging and Transhiatal Approach to Filum Terminale Externum Sectioning in Adolescents with Occult Tethered Cord Syndrome: Report of Four Cases. Pediatr Neurosurg 2020;55:432–438).
The OCCULT TETHERED CORD SYNDROME is therefore almost unknown in the medical community; in the medical literature to date "only" 563 scientific works have been published, compared to 34,692 on TETHERED CORD.
My patients are operated on with an innovative minimally invasive surgical technique under local anesthesia, which I have been performing since 2010, which reduces the possible complications of traditional surgery to only the skin incision, while it does not present the various complications, sometimes clinically relevant, of classical surgery (for detailed differences between minimally invasive surgery under local anesthesia and traditional surgery under general anesthesia see the dedicated page within my website CLICKING HERE).
This minimally invasive surgical technique under local anesthesia was described by myself for the first time in an international scientific journal: TECHNICAL CASE REPORT. Transhiatal Approach to Filum Terminale Externum Sectioning in Adult Patient With Tethered Cord Syndrome: Case Report. Operative Neurosurgery 15:E1–E4, 2018.
This minimally invasive surgery can also be applied in cases of TETHERED CORD.
Surgical procedures are currently performed at the "Per gli Infermi" Hospital in Faenza, previously also at the Hospitals of Lugo and Cattolica.
For information you can visit my website, within which I recommend watching the pre- and post-operative videos of patients treated for this pathology, the social media through which Italian and foreign patients, including those I have operated on, share experiences or through written patient testimonials see Qsalute :
CLICK HERE FOR Qsalute NEUROSURGERY HOSPITAL OF FAENZA
CLICK HERE FOR Qsalute HOSPITAL OF FAENZA
CLICK HERE FOR Qsalute HOSPITAL OF LUGO
Despite all the difficulties in obtaining a correct diagnosis, from 2010 to today I have operated on more than 400 patients from 19 of the 20 Italian regions, 34 patients from the European continent, 8 patients from the American continent, and 1 patient from the African continent.
The symptoms of patients affected by OCCULT TETHERED CORD SYNDROME are the same as those of TETHERED CORD, often the patients are young adults who have symptoms in the lower limbs, low back pain, and difficulty controlling the sphincters, often urinary and sometimes fecal (the various symptoms may not all be present at the same time), they have a standard lumbar MRI that is normal and often do not have the correct diagnosis and are referred to a psychologist and/or psychiatrist.
TETHERED CORD SYNDROME:
rare disease with a challenging diagnosis.
TETHERED CORD SYNDROME is present in some rare disease databases: ORPHANET, GARD, and NCI Thesaurus.
This pathology is supported in clinical diagnosis by standard lumbar MRI. The symptomatology of patients affected by TETHERED CORD SYNDROME is the same as those with OCCULT TETHERED CORD SYNDROME; often, patients are young adults who have symptoms in the lower limbs, lower back pain, and difficulty controlling the sphincters, often urinary and sometimes fecal as well (the various symptoms may not all be present at the same time).
Getting a diagnosis of these syndromes, TETHERED CORD and OCCULT TETHERED CORD, is not simple as evidenced by the news (click in the green box below to read it) of a mother who, for her child, managed, after consulting 17 different medical specialists, to get a diagnosis of tethered cord only with ChatGPT.
Researchers are examining the effects of ChatGPT in medicine.
An article published in May in Frontiers in Artificial Intelligence states that the technology has both advantages and disadvantages for medicine: "The potential applications of ChatGPT in the medical field range from identifying potential research topics to assisting professionals in clinical and laboratory diagnosis" and "despite its potential applications, the use of ChatGPT and other artificial intelligence tools in medical writing also raises ethical and legal concerns."
Having said that, this news highlights how ChatGPT can help identify the possible presence of rare diseases that are difficult to diagnose medically.
The difficulties in diagnosis are even greater for OCCULT TETHERED CORD SYNDROME because standard lumbar MRI is not helpful.
In my 13 years of experience in minimally invasive surgery in this field, it has never happened that a patient contacted me after obtaining a suspected diagnosis of TETHERED CORD using Artificial Intelligence, but times change and who knows if it will happen in the future.
Today, patients, both Italian and foreign, share their problems and experiences via social media, they get information from my website and then contact me.
INNOVATIVE VERTEBRAL SURGERY
MINIMALLY INVASIVE FOR THE EXTRADURAL SECTION OF THE FILUM TERMINALE UNDER LOCAL ANESTHESIA FOR THE TREATMENT OF TETHERED CORD AND OCCULT TETHERED CORD
A small skin incision is sufficient to perform, through the sacral hiatus, the minimally invasive surgical approach under local anesthesia to the sacral spinal canal
PRE AND POSTOPERATIVE VIDEOS
SURGERY: INNOVATIVE MINIMALLY INVASIVE SURGERY FOR THE EXTRADURAL SECTION OF THE FILUM TERMINALE UNDER LOCAL ANESTHESIA: procedure duration about 25 minutes, after one hour the patient can start walking again, discharge from the hospital the day after surgery
(SEE DEDICATED PAGE WITHIN THIS SITE).
PATHOLOGIES: tethered cord syndrome and occult tethered cord syndrome may be associated with slightly descended cerebellar tonsils (LLCT) or Chiari malformation.
SYMPTOMS: most symptoms are usually subjective. Symptoms in the lumbar region and lower limbs only rarely prevent normal walking.
We filmed patients with gait disorders before and after our innovative minimally invasive surgery under local anesthesia, documenting the incredible and immediate benefits.
CASE 1. 38-year-old woman.
Occult tethered cord syndrome.
CASE 2. 37-year-old woman.
Occult tethered cord syndrome.
CASE 3. 48-year-old man.
Occult tethered cord syndrome.
CASE 4. 39-year-old woman.
Tethered cord syndrome (L2) and mild descent (between 1 and 4 mm) of the cerebellar tonsils (LLCT).
CASE 5. 33-year-old woman.
Occult tethered cord syndrome, Ehlers Danlos syndrome, fibromyalgia and small fiber neuropathy.
CASE 6. 24-year-old woman.
Occult tethered cord syndrome, mild descent (between 1 and 4 mm) of the cerebellar tonsils (LLCT) and dorsal hydromyelia.
CASE 7. 13-year-old girl.
Occult tethered cord syndrome, cervical and dorsal hydromyelia, orthostatic tremor.
CASE 8. 38-year-old woman.
Tethered cord syndrome (L2) with lipomatous filum terminale.
CASE 9. 55-year-old woman.
Occult tethered cord syndrome.
CASE 10. 44-year-old woman
Tethered cord syndrome (L2) in Chiari type I malformation, cervical and dorsal syringomyelia.
CASE 11. 45-year-old woman.
Occult tethered cord syndrome in Chiari type I malformation.
CASE 12. 31-year-old woman.
Occult tethered cord syndrome and mild descent (between 1 and 4 mm) of the cerebellar tonsils (LLCT).
CASE 13. 15-year-old girl.
Occult tethered cord syndrome.
OUR SCIENTIFIC WORKS ON THE INNOVATIVE MINIMALLY INVASIVE SURGICAL TECHNIQUE IN LOCAL ANESTHESIA OF EXTRADURAL SECTION OF THE FILUM TERMINALE
Below you can read the abstracts of scientific articles we have published in international neurosurgery journals, "OPERATIVE NEUROSURGERY" and "PEDIATRIC NEUROSURGERY" (these are not OPEN ACCESS journals), which describe for the first time:
- Minimally invasive surgery under local anesthesia of sectioning the extradural filum terminale for the treatment of tethered cord;
- The innovative diagnostic-surgical protocol that involves the combination of prone lumbar magnetic resonance imaging and minimally invasive surgery with sectioning of the extradural filum terminale under local anesthesia for the treatment of occult tethered cord.
INNOVATIVE MICRO-SURGICAL TECHNIQUE WITH MINIMAL SKIN INCISION (MINIMAL INCISION MICROSURGERY - MIMS) DESCRIBED BY US FOR THE FIRST TIME AND PUBLISHED IN THE PRESTIGIOUS AMERICAN INTERNATIONAL SCIENTIFIC JOURNAL "OPERATIVE NEUROSURGERY"
SECTION OF THE FILUM TERMINALE EXTERNUM (EXTRADURAL)
With the Minimal Incision Microsurgery (MIMS) technique, under local anesthesia, the section of the filum terminale externum is performed through a small skin incision of about 4 centimeters.
This surgical technique has been performed by us since 2010, we have operated on about 400 Italian patients, 24 patients residing abroad, of whom 4 are in the American continent.
For more information, visit the pages within this website INNOVATIVE SURGERY: SECTION OF THE FILUM TERMINALE EXTERNUM UNDER LOCAL ANESTHESIA.
Innovative protocol with LUMBAR MRI IN PRONE POSITION and minimally invasive surgery of
SECTION OF THE FILUM TERMINALE EXTERNUM (EXTRADURAL) under local anesthesia for the diagnosis and surgical treatment of
OCCULT TETHERED CORD
Our innovative diagnostic and minimally invasive surgery protocol was published in the scientific journal Pediatric Neurosurgery in 2020 and involves the combination of prone lumbar MRI and the extradural (externum) section of the filum terminale under local anesthesia.
This diagnostic-surgical protocol was described by us for the first time in the international medical scientific literature.
The Italian patients operated on with this protocol are generally adult patients, to date there are about 400, some adolescent patients who underwent surgery were the subject of the aforementioned scientific work. In adult patients, occult tethered cord can present as a standalone condition or in association with the presence of slightly descended cerebellar tonsils, 0-4 mm (LLCT), or with Chiari malformation.
WHO WE ARE
We are a team of neurosurgeons who perform elective surgical procedures for degenerative diseases of the spine and for minimally invasive surgical treatment of tethered cord and occult tethered cord. We also perform surgical procedures for traumatic, tumoral, and entrapment pathologies of the peripheral nervous system.
CONTACT US
To book a neurosurgical consultation privately with Dr. Veronesi, you can call the toll-free number 800 00 44 88 of CupTel AUSL della Romagna from Monday to Friday from 8 am to 6 pm, and on Saturdays and days before holidays from 8 am to 1 pm.
Alternatively, medical appointments can be booked through the Electronic Health Record.
The clinic is inside the "per gli Infermi" Hospital of Faenza at Viale Stradone, 9.
The toll-free number 800 00 44 88 is not active for calls from outside Italy.
Foreign patients who wish to book a medical appointment can send a message by clicking on the GREEN box below and will receive the necessary information
WHAT THEY SAY ABOUT US: PATIENT REVIEWS
Qsalute is the Italian portal dedicated to Italian healthcare with reviews and opinions from patients about hospitals, doctors, medications, and patient discussions.
To read the reviews on the Qsalute website from patients treated at the Faenza Hospital, click on the GREEN box below for the page "NEUROSURGERY FAENZA HOSPITAL".
Other reviews can be read on the "FAENZA HOSPITAL" page, on the Qsalute website by clicking on the following link:
https://www.qsalute.it/ospedale-di-faenza/
The previous location of our surgical activity was at the Lugo Hospital (RA).
To read patient reviews on the page "NEUROSURGERY LUGO HOSPITAL" click on the following link:
http://www.qsalute.it/neurochirurgia-ospedale-lugo/
Information note on waiting lists for scheduled surgical admissions
The indication for scheduled admission for surgical intervention can be made by the Medical Director of the Facility to which the booking register belongs, either within the National Health System or in private practice.
When the proposal for admission is generated by a private practice visit by the internal or affiliated hospital specialist, there is no need for an additional institutional visit in order to include the patient in the booking lists.
At the time of being placed on the waiting list for surgery, the patient may choose between the institutional option with the National Health System, at no cost to the patient, and a private practice option with costs borne by the patient or their insurance.
The information contained on this site is intended for informational use only, not promotional and not a substitute for a medical visit or any ongoing therapies.
The information contained on this site is provided in compliance with articles 55, 56, and 57 as dictated by the Code of Medical Ethics of the NATIONAL FEDERATION OF ORDERS OF SURGEONS AND DENTISTS, May 18, 2014, and the related GUIDELINES - ORDER OF SURGEONS AND DENTISTS OF THE PROVINCE OF FORLÌ - CESENA Forlì June 13, 2007. Updated on 12/21/2010. Authorization from the Order of Doctors of Forlì-Cesena requested.
The information contained on this site is written and verified by Dr. Veronesi Vanni, and the date of the last update/modification is written on each page.
This site does not contain any form of purely commercial, promotional, or comparative advertising.
The cost of the site is fully self-financed.
All images, trademarks mentioned, and logos reproduced on the site http://www.vanniveronesi.com/ that were not produced by Dr. Veronesi Vanni belong to their legitimate owners. Said trademarks, images, and logos are mentioned for scientific, educational, or informational purposes.
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LAST MODIFIED SEPTEMBER 13 2025
AUSL ROMAGNA WEBSITE
VANNI VERONESI YOUTUBE CHANNEL
HOSPITAL ADDRESS
Hospital
"FOR THE SICK"
Viale Stradone, 9 Faenza (RA)
ZIP 48018
Italy
© Copyright 2020 Vanni VERONESI