George J. Garceau (1896–1977) and the first introduction of the “filum terminale syndrome”

Excerpt

The filum terminale syndrome is associated with spinal cord tethering and an abnormally positioned conus medullaris below L2–3 and often results in symptoms of a tethered cord [12]. This syndrome was first noticed and documented in the nineteenth century when the neurological, urological, and orthopedic manifestations associated with spina bifida occulta (SBO) were referred to as occult spinal dysraphism [8]. In 1910, Fuchs [1] speculated that incontinence seen in myelomeningocele patients during spinal flexion was due to increased tension on the distal spinal cord [6]. By 1940, Lichtenstein [7] furthered the concept of cord dysfunction secondary to tethering lesions [6]. However, it was not until 1953 when George J. Garceau (Fig. 1) [3] described the “filum terminale syndrome” (Fig. 2) hypothesizing that tension from an abnormally thickened filum terminale was responsible for spinal cord traction symptoms [6].

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