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Celal Bayar Üniversitesi, Tıp Fakültesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, Manisa, Türkiye Filum terminale is a ligament with a 2mm diameter. Thicker and fatty filum terminale is an abnormal structure that causes tethering effect to spinal cord, conus medullaris in particular, and ends up with clinical presentations such as urinary incontinence, scoliosis or pain. In this paper, the manifestations of tethered spinal cord due to abnormal filum terminale are explained. While the thick filum is a part of closed spinal disraphism, signs that make the physician alert for the presence of tight filum terminale are reviewed. Approach to such patients and choices of treatment are also discussed as well. Anahtar Kelimeler : Fatty filum termınale, Spinal disraphism, Tethered spinal cord