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Tethered cord

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https://www.readbyqxmd.com/read/29678699/acute-communicating-hydrocephalus-as-spinal-cord-surgery-complication-in-a-patient-with-lumbar-lipomyelocele-case-report
#1
Alessandro Prior, Mariasavina Severino, Andrea Rossi, Marco Pavanello, Gianluca Piatelli, Alessandro Consales
BACKGROUND: A lumbar lipomyelocele is a closed spinal dysraphism that can cause tethered cord syndrome. Between 5-15% of spinal dysraphism surgery cases are burdened with complications, the most common being wound infections or dehiscence and cerebrospinal fluid leak. Acute communicating hydrocephalus has never been described as a complication of this type of surgery. CASE DESCRIPTION: A 6-year-old girl, who had undergone several surgeries in another Institution for lumbar lipomyeloschisis, came to our attention for a second opinion about the management of her spinal dysraphism...
April 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29668630/thoracolumbar-spinal-neurenteric-cyst-with-tethered-cord-syndrome-and-extreme-cervical-lordosis-in-a-child-a-case-report-and-literature-review
#2
Zhi Gang Lan, Seidu A Richard, Chuanfen Lei, Siqing Huang
RATIONALE: Neurenteric cysts, are rare benign tumors of the central nervous system that are mostly located in the spinal cord and predominantly seen in male children although adult form of the disorder also occurs. The etiology and treatment of this disorder is still a matter of debate. Our case further throws more light on the pathogenesis and treatment of this disorder. PATIENT CONCERNS: A 4-year-old boy presented with 5-month history of cervical lordosis and bilateral lower extremity pain that progressed to his abdomen and upper body...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29660552/cervical-spine-and-cord-angle-mismatch-in-the-pathogenesis-of-myelopathy
#3
Tomasz Tykocki, Johannes du Plessis, Guy Wynne-Jones
BACKGROUND: Cervical myelopathy is a complex pathology and dynamic compression of the tethered cervical cord may be responsible for clinical symptoms METHODS: Patients with cervical canal stenosis who had magnetic resonance imaging (MRI) in flexion (F) and extension (E) positions were retrospectively reviewed. All cases were evaluated in Nurick grade. Based on MRI following cervical parameters were measured: cervical cord angle (CCA), cervical lordosis (C lordosis), spine/cord (S/C) angle ratio...
April 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29649647/the-clinical-outcomes-of-primary-and-revision-untethering-surgery-in-patients-with-tethered-cord-syndrome-and-spinal-bifida
#4
Jingchuan Sun, Yao Zhang, Haibo Wang, Yuan Wang, Yong Yang, Qingjie Kong, Ximing Xu, Jiangang Shi
BACKGROUND: Tethered cord syndrome (TCS) is an increasingly recognized clinical condition, with untethering surgery as the classically effective treatment. Yet, as evidence aggregated, the surgical outcome untethering, remains controversial. This study aimed to systematically evaluate the clinical outcomes after untethering surgery in primary and re-tethering patients. METHODS: This retrospective study was conducted by department of spine surgery of Changzheng Hospital from January to December 2016...
April 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29618070/congenital-dermal-sinus-and-limited-dorsal-myeloschisis-spectrum-disorders-of-incomplete-dysjuction-between-cutaneous-and-neural-ectoderms
#5
Ji Yeoun Lee, Sung-Hye Park, Sangjoon Chong, Ji Hoon Phi, Seung-Ki Kim, Byung-Kyu Cho, Kyu-Chang Wang
BACKGROUND: The existence of tethering tracts in spinal dysraphism, other than congenital dermal sinus (CDS), has been recognized and has been summated into an integrated concept of limited dorsal myeloschisis (LDM). OBJECTIVE: To elucidate the underlying embryology of LDM in relation to CDS by focusing on the pathological features of special cases of tethering tracts. METHODS: Out of 389 spinal dysraphism patients who were operated on from 2010 to 2016, 5 patients who had tethering tracts composed of both CDS and LDM (or "probable LDM" if only fibrous tissue was found) were identified...
March 29, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29617906/congenital-dermal-sinus-and-limited-dorsal-myeloschisis-spectrum-disorders-of-incomplete-dysjuction-between-cutaneous-and-neural-ectoderms
#6
Ji Yeoun Lee, Sung-Hye Park, Sangjoon Chong, Ji Hoon Phi, Seung-Ki Kim, Byung-Kyu Cho, Kyu-Chang Wang
BACKGROUND: The existence of tethering tracts in spinal dysraphism, other than congenital dermal sinus (CDS), has been recognized and has been summated into an integrated concept of limited dorsal myeloschisis (LDM). OBJECTIVE: To elucidate the underlying embryology of LDM in relation to CDS by focusing on the pathological features of special cases of tethering tracts. METHODS: Out of 389 spinal dysraphism patients who were operated on from 2010 to 2016, 5 patients who had tethering tracts composed of both CDS and LDM (or "probable LDM" if only fibrous tissue was found) were identified...
March 29, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29605699/tailored-strategies-to-manage-cerebrospinal-fluid-leaks-or-pseudomeningocele-post-surgery-for-tethered-cord-syndrome
#7
Suhas Udayakumaran, Chetan T Rathod
BACKGROUND: Cerebrospinal fluid (CSF) leaks are a dreaded complication after surgery for tethered cord and are associated with significant patient morbidity. Although many strategies for managing postoperative CSF leaks exist, this problem is still daunting, especially in the very young patients. In this article, the authors compared different management techniques for CSF leaks or significant pseudomeningocele in patients with tethered cord syndrome (TCS). METHODS: We analysed a cohort of children who underwent surgery for TCS from January 2011 to March 2016 (n = 260) and postoperatively experienced either a CSF leak or significant pseudomeningocele...
March 29, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29602552/screening-practices-and-associated-anomalies-in-infants-with-anorectal-malformations-results-from-the-midwest-pediatric-surgery-consortium
#8
Peter C Minneci, Rashmi S Kabre, Grace Z Mak, Devin R Halleran, Jennifer N Cooper, Amin Afrazi, Casey M Calkins, Cynthia D Downard, Peter Ehrlich, Jason Fraser, Samir K Gadepalli, Michael A Helmrath, Jonathan E Kohler, Rachel Landisch, Matthew P Landman, Constance Lee, Charles M Leys, Daniel L Lodwick, Rodrigo Mon, Beth McClure, Beth Rymeski, Jacqueline M Saito, Thomas T Sato, Shawn D St Peter, Richard Wood, Marc A Levitt, Katherine J Deans
BACKGROUND: This study evaluates screening practices and the incidence of associated anomalies in infants with anorectal malformations (ARM). METHODS: We performed a multi-institutional retrospective cohort study of children born between 2007 and 2011 who underwent surgery for ARM at 10 children's hospitals. ARM type was classified based on the location of the distal rectum, and all screening studies were reviewed. RESULTS: Among 506 patients, the most common ARM subtypes were perineal fistula (40...
March 7, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29588075/surgical-management-of-functional-constipation-an-intermediate-report-of-a-new-approach-using-a-laparoscopic-sigmoid-resection-combined-with-malone-appendicostomy
#9
Alessandra Gasior, Carlos Reck, Alejandra Vilanova-Sanchez, Karen A Diefenbach, Desalegn Yacob, Peter Lu, Karla Vaz, Carlo Di Lorenzo, Marc A Levitt, Richard J Wood
INTRODUCTION: We previously reported our surgical technique for functional constipation for patients who have failed medical management using a novel collaborative approach with gastroenterology input, pre-operative contrast enema, colonic manometry, and laxative protocol combined with a laparoscopic colonic resection with Malone appendicostomy. Now we report our intermediate outcomes. METHODS: Patients who failed bowel management program for functional constipation were reviewed from 3/2014-2/2017...
March 7, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29561460/spinal-dysraphism-and-dislocated-hip-beware-of-anomalous-sciatic-nerve-through-ilium-a-case-report
#10
Amanda T Whitaker, James Kasser, Young-Jo Kim
RATIONALE: The sciatic nerve runs a predictable course combining L4-S3 nerve roots through the true pelvis and under the greater sciatic notch. There are reports of bony protuberances from the sacrum and ilium in cases of spinal dysraphism; however advanced imaging, treatment, or outcomes are not described. There are no cases with associated fibular hemimelia in the current literature. PATIENT CONCERNS: This is a 4-year-old girl with tethered cord, acetabular dysplasia with hip subluxation, congenital short femur, anterior cruciate ligament (ACL) deficiency, and fibular hemimelia with her sciatic nerve coursing through the ilium...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29538204/spinal-cord-infarction-caused-by-sacral-canal-epidural-steroid-injection-a-case-report
#11
Gang Wang, Jing Liang, Zishan Jia, Lei Wan, Mingxia Yang
RATIONALE: Spinal cord infarction is one of the complications of epidural steroid injections (ESIs), but has only been reported in cervical vertebra by transforaminal injection and lumbar vertebra by transforaminal injection; and up to now, there is no reporting about spinal cord infarction caused by caudal injection. Here, we report a case. PATIENT CONCERNS: A 52-year-old man was admitted to our hospital. He was diagnosed as lumbar disc herniation in other hospital, and the patient suffered bilateral lower limb motor and sensory disorders after administration of caudal ESI...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29528274/spine-shortening-osteotomy-for-patients-with-tethered-cord-syndrome-a-systematic-review-and-meta-analysis
#12
Weiwei Lin, Hongtao Xu, Guman Duan, Jinjin Xie, Yisheng Chen, Baohua Jiao, Haitao Lan
Purpose Tethered cord syndrome (TCS) is the clinical manifestation of an abnormal stretch on the spinal cord, caused by several pathological conditions. Tethered cord release is the gold standard treatment for TCS. However, direct untethering carries potential risks of spinal cord injury, post-operative retethering, and CSF-related complications. Spine-shortening osteotomy (SSO) has recently been performed as an alternative technique to avoid these risks. We aimed to systematically review the literature on indications and outcome of SSO in TCS patients...
March 12, 2018: Neurological Research
https://www.readbyqxmd.com/read/29523203/computer-simulation-of-syringomyelia-in-dogs
#13
Srdjan Cirovic, Robert Lloyd, Jelena Jovanovik, Holger A Volk, Clare Rusbridge
BACKGROUND: Syringomyelia is a pathological condition in which fluid-filled cavities (syringes) form and expand in the spinal cord. Syringomyelia is often linked with obstruction of the craniocervical junction and a Chiari malformation, which is similar in both humans and animals. Some brachycephalic toy breed dogs such as Cavalier King Charles Spaniels (CKCS) are particularly predisposed. The exact mechanism of the formation of syringomyelia is undetermined and consequently with the lack of clinical explanation, engineers and mathematicians have resorted to computer models to identify possible physical mechanisms that can lead to syringes...
March 9, 2018: BMC Veterinary Research
https://www.readbyqxmd.com/read/29492126/pure-tethered-cervical-cord-and-review-of-literature
#14
Vinod Kumar Tewari, Rituj Somvanshi, Ravindra Bihari Trivedi, Mazhar Hussain, H K Das Gupta, R S Dubey
Tethering of the spinal cord in the lumbosacral region with myelomeningocele is a well-known phenomenon. Only sporadic cases of tethering along the rest of the neuraxis, including the hindbrain, cervical, and thoracic spinal cord have been documented, always along with some associated congenital malformations (hydrocephalus, Chiari malformation, myelomeningocele, meningocele, hamartomatous stalk, spina bifida occulta, intramedullary lipoma, intradural fibrous adhesions, the fusion of the sixth and seventh cervical vertebrae, split cord malformation, or low-lying cord)...
January 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29481675/human-amniotic-membrane-for-the-prevention-of-intradural-spinal-cord-adhesions-retrospective-review-of-its-novel-use-in-a-case-series-of-14-patients
#15
Corey T Walker, Jakub Godzik, U Kumar Kakarla, Jay D Turner, Alexander C Whiting, Peter Nakaji
BACKGROUND: Tethering after spinal surgery is caused by adhesions that arise from intradural tissue manipulation. Microsurgical detethering is the only treatment for symptomatic patients, but retethering occurs commonly and no treatment is widely available to prevent this complication. OBJECTIVE: To apply human amniotic membrane (HAM) grafts, which are immune-privileged and known to possess antifibrogenic properties, in patients requiring microsurgical detethering...
February 22, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29473815/incidence-of-symptomatic-tethered-spinal-cord-in-pediatric-patients-presenting-with-neurofibromatosis-types-1-and-2
#16
Carolyn S Quinsey, Katie Krause, Lissa C Baird, Christina M Sayama, Nathan R Selden
OBJECTIVE The relationship between a tethered cord (TC) and neurofibromatosis type 1 (NF1) and NF2 is not known. The purpose of this study was to define the incidence of TC in pediatric neurosurgical patients who present with NF. METHODS The authors performed a single-institution (tertiary care pediatric hospital) 10-year retrospective analysis of patients who were diagnosed with or who underwent surgery for a TC and/or NF. Clinical and radiological characteristics were analyzed, as was histopathology. RESULTS A total of 424 patients underwent surgery for a TC during the study period, and 67 patients with NF were seen in the pediatric neurosurgery clinic...
February 23, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29454133/prevalence-and-risk-factors-for-neural-axis-anomalies-in-idiopathic-scoliosis-a-systematic-review
#17
REVIEW
Johan L Heemskerk, Moyo C Kruyt, Dino Colo, René M Castelein, Diederik H R Kempen
BACKGROUND: There is ongoing controversy about the routine use of magnetic resonance imaging (MRI) preoperatively in patients with presumed idiopathic scoliosis (IS). Routine MRI can help identify possible causes for the deformity and detect anomalies which could complicate deformity surgery. However, routine MRI increases health care costs significantly and may reveal mild variations from normal without clinical relevance, that can still lead to anxiety and influence decision making...
February 14, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29451451/critical-assessment-of-pediatric-neurosurgery-patient-parent-educational-information-obtained-via-the-internet
#18
Michael Garcia, Christopher Daugherty, Bertha Ben Khallouq, Todd Maugans
OBJECTIVE The Internet is used frequently by patients and family members to acquire information about pediatric neurosurgical conditions. The sources, nature, accuracy, and usefulness of this information have not been examined recently. The authors analyzed the results from searches of 10 common pediatric neurosurgical terms using a novel scoring test to assess the value of the educational information obtained. METHODS Google and Bing searches were performed for 10 common pediatric neurosurgical topics (concussion, craniosynostosis, hydrocephalus, pediatric brain tumor, pediatric Chiari malformation, pediatric epilepsy surgery, pediatric neurosurgery, plagiocephaly, spina bifida, and tethered spinal cord)...
February 16, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29439906/dermoid-cysts-of-the-conus-medullaris-clinical-review-case-series-and-management-strategies
#19
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
#20
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
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