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Tethered cord

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https://www.readbyqxmd.com/read/29439906/dermoid-cysts-of-the-conus-medullaris-clinical-review-case-series-and-management-strategies
#1
Salah G Aoun, Mary Ashley Liu, Megan Still, Tarek Y El Ahmadieh, Mazin Al Tamimi, Wayne Gluf
BACKGROUND: The management of dermoid cysts can be tedious as they have a tendency to recur, and respond poorly to chemotherapy and radiation. Management is especially difficult for tumors involving highly eloquent areas such as the conus medullaris. OBJECTIVE: We aim to provide a summary of the pathology, clinical presentation, and operative management strategies of dermoid cysts involving the conus medullaris. METHODS: Two clinical cases of dermoid cysts of the conus are presented, as well as a commented surgical video...
February 10, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29421991/association-of-early-onset-spasticity-and-risk-for-cognitive-impairment-with-mutations-at-amino-acid-499-in-spast
#2
Meredith K Gillespie, Peter Humphreys, Hugh J McMillan, Kym M Boycott
Hereditary spastic paraplegia is a phenotypically and genetically heterogeneous group of neurodegenerative disorders characterized by lower extremity weakness and spasticity. Spastic paraplegia 4 (SPG4), caused by heterozygous mutations in the gene SPAST, typically causes a late-onset, uncomplicated form of hereditary spastic paraplegia in affected individuals. Additional clinical features in SPG4 have been reported on occasion, but no genotype-phenotype correlation has been established. Through targeted clinical testing, we identified 2 unrelated female patients with the same de novo p...
January 1, 2018: Journal of Child Neurology
https://www.readbyqxmd.com/read/29409774/adult-tethered-cord-syndrome-following-chiari-decompression
#3
Christina Jackson, Brian W Yang, Wenya Linda Bi, E Antonio Chiocca, Michael W Groff
BACKGROUND: Adult tethered cord syndrome is a rare neurological disorder that classically presents with back or leg pain, weakness, and urinary dysfunction. Spinal cord tethering has been associated with acquired Chiari malformations. While the effects of tethered cord release on Chiari malformation symptoms have been previously described, we report an unusual case of acquired tethered cord syndrome following Chiari decompression. CASE DESCRIPTION: We report a 68-year-old man with a history of distant T12-level spinal cord injury who presented with two weeks of progressive bilateral lower extremity weakness...
January 31, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29367470/minimally-invasive-surgical-approach-to-filum-lipoma
#4
Toshiaki Hayashi, Tomomi Kimiwada, Misaki Kohama, Reizo Shirane, Teiji Tominaga
Filum terminale lipoma (FTL) causes various spinal symptoms known as tethered cord syndrome. The treatment for FTL is surgical untethering by sectioning the FTL, which can prevent symptom progression and often results in improvement of symptoms. This report describes a minimally invasive surgical strategy that we have introduced for FTL sectioning. The pediatric patients with FTL since 2007 were treated using this minimally invasive surgical strategy, which we refer to as an interlaminar approach (ILA). In summary, the surgical technique involves: minimal skin incision to expose the unilateral ligamentum flavum in the lower lumbar region; ligamentum flavum incision to expose the dural sac, and dural incision followed by identification and sectioning of the filum...
January 23, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29357575/re-comprehensive-analysis-of-the-clinical-and-urodynamic-outcomes-of-secondary-tethered-spinal-cord-before-and-after-spinal-cord-untethering
#5
Douglas A Canning
No abstract text is available yet for this article.
February 2018: Journal of Urology
https://www.readbyqxmd.com/read/29357573/re-comprehensive-analysis-of-the-clinical-and-urodynamic-outcomes-of-primary-tethered-spinal-cord-before-and-after-spinal-cord-untethering
#6
Douglas A Canning
No abstract text is available yet for this article.
February 2018: Journal of Urology
https://www.readbyqxmd.com/read/29350777/the-pathology-of-lumbosacral-lipomas-macroscopic-and-microscopic-disparity-have-implications-for-embryogenesis-and-mode-of-clinical-deterioration
#7
Victoria Jones, Victoria Wykes, Nicki Cohen, Dominic Thompson, Thomas S Jacques
AIMS: Lumbosacral lipomas (LSL) are congenital disorders of the terminal spinal cord region that have the potential to cause significant spinal cord dysfunction in children. They are of unknown embryogenesis with variable clinical presentation and natural history. It is unclear whether the spinal cord dysfunction reflects a primary developmental dysplasia or whether it occurs secondarily to mechanical traction (spinal cord tethering) with growth. Whilst different anatomical subtypes are recognised and classified according to radiological criteria, these subtypes correlate poorly with clinical prognosis...
January 19, 2018: Histopathology
https://www.readbyqxmd.com/read/29343914/symptomatic-lower-urinary-tract-dysfunction-in-sacral-agenesis-potentially-high-risk
#8
Sanjay Sinha, Mehul A Shah, Dilip M Babu
Introduction: Sacral agenesis (SA) is a caudal regression anomaly that can cause neurogenic bladder but is not generally recognized as high risk. We studied the clinical presentation, upper urinary tract, bone and spine abnormalities, and urodynamic findings in patients with SA and compared them with related high-risk conditions, anorectal malformation (ARM), and cloacal malformation. Materials and Methods: Patient records between May 2011 and December 2015 were identified and grouped into isolated SA without an overt anomaly (Group I), SA with overt caudal regression anomalies (Group II), and ARM or cloacal malformation without the SA (Group III)...
January 2018: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/29332115/ultrasound-guided-transversus-abdominis-plane-block-postoperative-analgesia-in-children-with-spinal-dysraphism
#9
Eralp Çevikkalp, Koray Erbüyün, Serpil Erbüyün, Gülay Ok
Pediatric regional anesthesia is widely used to relieve postoperative pain after abdominal surgery. Commonly used techniques of regional anesthesia include lumbar epidural and caudal block. However, the use of central neuraxial blockade has limitations. It is contraindicated in patients with clotting abnormalities, spinal dysraphism with tethered cord syndrome, meningomyelocele, and following spinal surgery with instrumentation. Ultrasound guided transversus abdominis plane block is a new method of regional anesthesia that can be used in settings where central neuraxial blockade is contraindicated...
January 2018: Saudi Medical Journal
https://www.readbyqxmd.com/read/29284599/spinal-arteriovenous-vascular-malformations-in-patients-with-neural-tube-defects
#10
E Giordan, C Bortolotti, G Lanzino, W Brinjikji
BACKGROUND AND PURPOSE: Neural tube defects, such as tethered cord, intradural lipoma, or myelomeningocele may coexist with spinal vascular malformations. The coexistence of these 2 rare entities is suggestive of a causal relationship between them, which may lead to further understanding of their pathogenesis. We present a series of 6 patients with epidural spinal arteriovenous fistulas associated with neural tube defects. MATERIALS AND METHODS: We retrieved cases of spinal vascular malformations associated with neural tube defects seen at our institution...
December 28, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29260294/fatty-filum-terminale-fft-as-a-secondary-tethering-element-in-children-with-closed-spinal-dysraphism
#11
Ankush Gupta, Vedantam Rajshekhar
PURPOSE: The purpose of this study was to assess the prevalence of FFT as an additional tethering element in children operated for closed spinal dysraphism, where FFT was not the primary tethering pathology. METHODS: This is a retrospective study of 195 children (< 18 years of age) who underwent surgery for closed spinal dysraphism and did not have FFT as the primary diagnosis. All patients were operated during the period 2005-2017 by a single surgeon. The commonest diagnosis was a lipomyelomeningocele (LMMC, n = 81, 41...
December 19, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29236600/benefit-of-intraoperative-neurophysiological-monitoring-in-a-pediatric-patient-with-spinal-dysmorphism-split-cord-malformation-and-scoliosis
#12
Faisal R Jahangiri, Samir Al Sayegh, Moutasem Azzubi, Abdulrahman M Alrajhi, Monerah M Annaim, Shmoukh A Al Sharif, Tanweer Aziz, Sami Al Eissa
Intraoperative neurophysiological monitoring (IONM) consists of a group of neurodiagnostic techniques that assess the nervous system's functional integrity during surgical operations. A retrospective analysis of a pediatric female patient was conducted who underwent 12 operations for the correction of scoliosis, tethered cord, and split spinal cord wherein IONM played an important role. From age 3 to 6, she underwent six procedures including a release of the tethered cord, resection of the filum terminale, removal of a T11-T12 bony spur, release of L3 adhesions, repair of subcutaneous meningocele, and correction of scoliosis with a vertical expandable prosthetic titanium rod (VEPTR) technique without the use of IONM...
2017: Neurodiagnostic Journal
https://www.readbyqxmd.com/read/29144251/evaluation-of-dorsal-midline-discolorations-with-physical-examination-and-ultrasound
#13
Liat Ben-Sira, Penina Ponger, Shlomi Constantini
OBJECTIVE: To assess the association between dorsal midline skin discolorations, tethering of the spinal cord, and the role of ultrasound screening of these stigmata, focusing specifically on vascular lesions. STUDY DESIGN: We conducted a prospective observational study of infants <6 months of age with suspicious dorsal midline skin stigmata. All were evaluated by physical examination and ultrasound scan. A subset also had a magnetic resonance imaging examination...
November 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29129155/transgenerational-inheritance-of-familial-lipomyelomeningocele
#14
Thomas Larrew, Ramin Eskandari, Kenton R Holden, Amy Chen, Catherine J Spellicy, Julie R Jones, Jennifer A Lee, Michael J Lyons
Lipomyelomeningocele is a type of neural tube defect characterized by lipomatous tissue causing a defect in the vertebrae, infiltrating the dura, and tethering the spinal cord. Despite significant neurologic consequences, the underlying etiology remains poorly understood. We present a father and son with remarkably similar presentations of lipomyelomeningocele. Genetic testing did not reveal an underlying cause but whole exome sequencing identified variants in the ARHGAP29 and RADIL genes in the proband and his affected father...
December 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/29104840/spinal-shortening-for-recurrent-tethered-cord-syndrome-via-a-lateral-retropleural-approach-a-novel-operative-technique
#15
Jeffrey A Steinberg, Arvin R Wali, Joel Martin, David R Santiago-Dieppa, David Gonda, William Taylor
Spine shortening via vertebral osteotomy (SSVO) for recurrent tethered cord syndrome (TCS) is a novel surgical technique that avoids the complication profile associated with revision detethering. While SSVO has previously been described via a posterior approach, we describe a lateral retropleural approach for SSVO in recurrent TCS in a 21-year-old female. Our patient presented with progressive lower extremity weakness, bowel and bladder incontinence, and back pain in the setting of childhood repair of myelomeningocele and two previous detethering procedures...
August 31, 2017: Curēus
https://www.readbyqxmd.com/read/29101613/retained-medullary-cord-extending-to-a-sacral-subcutaneous-meningocele
#16
Nobuya Murakami, Takato Morioka, Takafumi Shimogawa, Kimiaki Hashiguchi, Nobutaka Mukae, Kazuyoshi Uchihashi, Satoshi O Suzuki, Koji Iihara
BACKGROUND: A retained medullary cord (RMC) is a rare closed spinal dysraphism with a robust elongated neural structure continuous from the conus and extending to the dural cul-de-sac. One case extending down to the base of a subcutaneous meningocele at the sacral level has been reported. CLINICAL PRESENTATION: We report on three cases of closed spinal dysraphism, in which a spinal cord-like tethering structure extended out from the dural cul-de-sac and terminated at a skin-covered meningocele sac in the sacrococcygeal region, which was well delineated in curvilinear coronal reconstructed images of 3D-heavily T2-weighted images (3D-hT2WI)...
November 3, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29082228/a-pregnant-woman-with-spina-bifida-need-for-a-multidisciplinary-labor-plan
#17
Mary Angela O'Neal
Women with spina bifida present both obstetrical and anesthesia challenges. They are more likely to require a caesarian delivery and traditionally neuraxial anesthesia has been avoided due to concerns of worsening neurologic disability. The case of a pregnant woman with a history of a surgically corrected lipomeningocele and tethered cord is presented to illustrate the need for a comprehensive labor plan.
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29076793/magnetic-resonance-imaging-in-the-prone-position-and-the-diagnosis-of-tethered-spinal-cord
#18
Melissa M Stamates, David M Frim, Carina W Yang, Gregory L Katzman, Saad Ali
OBJECTIVE Tethered cord syndrome (TCS) is a neurosurgical disorder with varied clinical manifestations believed to result from vascular compromise due to stretch forces on the spinal cord. Conventional supine MRI findings may include a low-lying conus medullaris, thickened or fat-infiltrated filum terminale, or lipoma; however, imaging sensitivity and specificity for tethered cord can be low. The purpose of this study was to evaluate the utility of prone MRI in the diagnosis of tethered and retethered spinal cord...
October 27, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29067499/prognosis-of-surgical-treatment-of-the-tethered-cord-syndrome-in-children
#19
Kirill Sysoev, Arsen Tadevosyan, Konstantin Samochernykh, William Khachatryan
PURPOSE: The aim of this study was to identify the factors relevant to the prognosis of the outcome of the surgical treatment of the tethered cord syndrome (TCS). METHODS: The results of surgical treatment performed on 58 children with TCS were analyzed, with follow-up periods ranging from 6 months to 5 years. The data of preoperative clinical and instrumental examinations, as well as those of intraoperative electrophysiological diagnostics and morphometry, were compared with the dynamics of the TCS clinical presentation...
October 24, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29058245/ocular-findings-in-a-patient-with-oculofaciocardiodental-ofcd-syndrome-and-a-novel-bcor-pathogenic-variant
#20
Yujia Zhou, Antonina Wojcik, Victoria R Sanders, Bahram Rahmani, Sudhi P Kurup
PURPOSE: To report a case of OFCD associated with a de novo BCOR pathogenic variant and highlight the ocular findings and possible mechanisms. METHODS: A retrospective chart review of the patient's ocular and systemic findings was performed. The patient underwent diagnostic whole exome sequencing (WES). RESULTS: The patient had a comprehensive eye exam in infancy demonstrating bilateral congenital cataracts consisting of posterior lenticonus with a posterior cortical opacity...
October 22, 2017: International Ophthalmology
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