Abstract

Filum terminale lipomas (FTLs) are congenital lumbosacral anomalies that can cause tethered cord syndrome (TCS). Most patients with TCS caused by FTL are children, and these are only rarely present in adults. A 64-year-old male presented with long-standing bilateral lower-limb weakness and bladder dysfunction. The lumbar magnetic resonance imaging revealed an FTL of the conus, which was not displaced. Following sectioning, the patient's bilateral lower limb weakness resolved, and his bladder function improved. TCS caused by an FTL in late middle-aged patients is rare. After undergoing untethering with resection of the lipoma, the patient sustained resolution of his motor deficit and improvement in his bladder function.

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