Filum terminale

Organization and role

The filum is not a motor or sensory cauda equina nerve root. Its intradural portion continues as a dural-covered portion attached toward the coccyx.

Clinical relevance and investigation

A thickened or fatty filum may be considered when evaluating tethered cord. Appearance alone is insufficient: symptoms, conus position and neurological findings matter.

Points to consider

The vertebral level and compartment should be specified. A normal fluid-filled space, a meningeal covering and a pathological collection are different concepts. Relationships to the cord and roots help explain possible symptoms.

Role of TAGMED care

At TAGMED, assessment aims to understand symptoms, history and functional limitations. Manual care and osteopathy, motorized spinal decompression, laser and shockwave have different indications. The term described in this entry is not enough to select any of these modalities. Their relevance, limitations and possible contraindications should be discussed in relation to diagnosis and individual goals.

Related concepts and distinctions

These concepts belong to the same field, but are not synonyms.

• Subarachnoid space — Space between the arachnoid and pia containing cerebrospinal fluid around the spinal cord and nerve roots.
• Denticulate ligaments — Lateral extensions of the pia that connect the spinal cord to the dura and help stabilize it within the spinal canal.
• Spinal pia mater — Thin vascular membrane closely attached to the spinal cord surface, forming the innermost layer of its meningeal coverings.

Medical references

1. OpenStax, Rice University. Anatomy and Physiology 2e — The Central Nervous System.
2. Radiological Society of North America. RadLex Radiology Lexicon — terminology resource.

References document the topic; their inclusion does not imply endorsement of TAGMED services by those organizations.