Fatty Filum

Fatty filum, also known as lipoma of the filum terminale, is a condition in which the filum terminale, a fibrous thread anchoring the spinal cord to the tailbone, contains an abnormal deposit of fat. This fatty infiltration causes the filum to become thickened and inelastic, leading to tethering of the spinal cord. Though it may be asymptomatic at birth, over time, especially during periods of growth, the tethered cord can become stretched, causing neurological deficits, orthopedic deformities, and bladder/bowel dysfunction. It is one of the most common causes of occult (hidden) spinal dysraphism. 🌍 Why It Matters in Bangladesh In Bangladesh, fatty filum is often missed in infancy, as routine spinal screening is not standard practice. Many children present late with weakness in the legs, abnormal walking patterns, or urinary problems. Parents and even primary care providers may misinterpret symptoms as developmental delay or cerebral palsy. At the National Institute of Neurosciences & Hospital (NINS) and the Bangladesh Paediatric Neurocare Centre, Dr. Md. Nafaur Rahman offers timely diagnosis and expert microsurgical intervention to treat fatty filum and prevent irreversible spinal cord damage. 🧬 How Does a Fatty Filum Affect the Child? The fat prevents normal elasticity of the filum, which should allow the spinal cord to move freely with growth This results in increased tension and stretching of the spinal cord Over time, the tethered cord leads to: Reduced blood flow Nerve injury Progressive neurological decline 🧒 Common Signs & Symptoms Children with a fatty filum may initially be asymptomatic but develop symptoms as they grow: Leg weakness, stiffness, or clumsiness Toe walking or abnormal gait Foot deformities (e.g., clubfoot, high arch) Back pain, especially in the lower spine Incontinence or recurrent urinary tract infections Constipation or loss of bowel control Skin markers: dimple, hairy patch, lipoma, or skin tag in lower back Symptoms often worsen with age or after growth spurts. 🔍 Diagnostic Evaluation 🧠 MRI of Lumbosacral Spine Gold standard imaging to identify: Fat in the filum terminale Thickness of filum (>2mm is abnormal) Tethered conus medullaris (ending below L2) 🧪 Urodynamic Study Recommended if there are bladder control issues 🧬 Neurological and Orthopedic Assessment To assess lower limb strength, reflexes, and spinal deformities 🛠️ Treatment: Microsurgical Filum Sectioning The definitive treatment is surgical detethering, specifically sectioning the fatty filum, to relieve tension on the spinal cord. ✂️ Surgical Goals: Release the tethered cord Prevent progression of symptoms Preserve or restore neurological function Minimize risk of spinal deformity or incontinence The procedure is minimally invasive, done under a microscope for high precision, and usually involves a short hospital stay. 🔄 Post-Surgical Outcomes & Follow-Up Most children experience stabilization or improvement of symptoms Earlier intervention leads to better outcomes Requires long-term follow-up to monitor for: Retethering Spinal alignment Bladder and motor function Rehabilitation and physiotherapy may be needed for children with pre-existing deficits. 👨‍⚕️ Why Trust Dr. Md. Nafaur Rahman? One of Bangladesh’s leading pediatric neurosurgeons in managing tethered cord syndromes and spinal dysraphism Over a decade of experience in microsurgical detethering Operates at the National Institute of Neurosciences & Hospital (NINS) and Bangladesh Paediatric Neurocare Centre Offers multidisciplinary care, including: Pediatric urology Pediatric orthopedics Child physiotherapy and developmental support Trusted by hundreds of families across Bangladesh for safe, timely, and effective surgery 📞 Contact for Evaluation & Surgery Dr. Md. Nafaur Rahman Assistant Professor, Pediatric Neurosurgery, NINS Chief Consultant, Bangladesh Paediatric Neurocare Centre 📞 For Appointments/Referrals: 01912988182 | 01607033535 🌐 Visit: www.neurosurgeonnafaur.com