ArticleBMC surgery2024
The discrepancy in triggered electromyography responses between fatty filum and normal filum terminale.
Article in BMC surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 3 citations in OpenAlex.
- Morphological analysis of the filum terminale and detailed description of the distal filum terminale externum: a cadaveric study.Frontiers in neuroanatomy · 2025Article
- Occult tethered cord syndrome: insights into clinical and MRI features, prognostic factors, and treatment outcomes in 30 dogs with confirmed or presumptive diagnosis.Frontiers in veterinary science · 2025Article
- Anatomical and histological characterization of the filum terminale in dogs.Frontiers in veterinary science · 2025Article
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8 authors at 4 institutions in 1 country.
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Abstract
backgroundFunctional role of filum terminale (FT) was not well studied though it contains structure basis for nerve impulse conduction. We aimed to explore the possible functions of the FT from the perspective of triggered electromyography (EMG) during surgery.
methodsWe retrospectively reviewed intraoperative neurophysiological monitoring data from pediatric patients who underwent intradural surgeries at the lumbar level in Shanghai Children's. Hospital from January 2018 to March 2023. Altogether 168 cases with complete intraoperative neurophysiological recordings of the FT were selected for further analysis. Triggered EMG recordings of the filum originated from two main types of surgeries: selective dorsal rhizotomy (SDR) and fatty filum transection.
results96 cases underwent SDR and 72 cases underwent fatty filum transection. Electrical stimulation of the FT with fatty infiltration did not elicit electromyographic activity in the monitored muscles with the maximum stimulus intensity of 4.0 mA, while the average threshold for FT with normal appearance was 0.68 mA, and 89 out of 91 FT could elicit electromyographic responses in monitored channels. The threshold ratio of filum to motor nerve roots at the same surgical segment was significantly higher in patients with fatty filum, and a cut-off point of 21.03 yielded an area under curve of 0.943, with 100% sensitivity and 85.71% specificity.
conclusionFilum with normal appearance can elicit electromyographic activity in the lower limbs/anal sphincter similar to the performance of the cauda equina nerve roots. The threshold of fatty filum is different from that of normal appearing FT. Triggered EMG plays an important role in untethering surgeries.
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