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| Occult Tight Filum Terminale Syndrome (OTFTS) |
Occult Tight Filum Terminale Syndrome (OTFTS)
Definition:
Occult Tight Filum Terminale Syndrome (OTFTS) is a disorder which shares the same clinical findings as tethered cord syndrome,
but on radiologic exam, the conus of the spinal cord ends in a normal position. OTFTS can be present in patients diagnosed
with Spina Bifida Occulta and Chiari I Malformation.
Diagnosis:
Diagnosis is typically made using an MRI of the lumbar spine, and clinical exam.
Symptoms:
Symptoms can include those typically seen in Tethered Cord Syndrome (TCS); progressive bladder dysfunction
(including hesitancy, incontinence, and urinary retention), chronic constipation or fecal incontinence, lower extremity
weakness, gait changes, reflex abnormalities, leg/back pain, scoliosis, and sensory abnormalities in the lower extremities.
Treatment:
Surgical release of the filum terminale in this situation is considered controversial. Some physicians prefer to watch the
symptoms over time, and order urological testing to rule out non-neurological causes of bladder dysfunction. They may also
try conservative treatments before considering surgery.
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