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Tethered spinal cord

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https://www.readbyqxmd.com/read/29350777/the-pathology-of-lumbosacral-lipomas-macroscopic-and-microscopic-disparity-have-implications-for-embryogenesis-and-mode-of-clinical-deterioration
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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/29076793/magnetic-resonance-imaging-in-the-prone-position-and-the-diagnosis-of-tethered-spinal-cord
#11
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
#12
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/29055742/clinical-evaluation-of-an-innovative-operative-procedure-in-the-treatment-of-the-tethered-cord-syndrome
#13
Yang Hou, Jingchuan Sun, Jiangang Shi, Yongfei Guo, Yuan Wang, Guodong Shi, Guohua Xu
BACKGROUND CONTEXT: The tethered cord syndrome (TCS) characterized by urination dysfunction has long been a worldwide clinical problem, of which clinical effects remains controversial. PURPOSE: The objective of this study was to evaluate the clinical effects of an innovative surgical method for the treatment of TCS. STUDY DESIGN: This is a retrospective clinical study. PATIENT SAMPLE: There were 15 patients included in this study...
October 18, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29053056/intradural-spine-surgery-may-not-carry-an-increased-risk-of-shunt-revision-compared-with-extradural-spine-surgery-in-pediatric-patients-with-myelomeningocele
#14
Elizabeth N Kuhn, Betsy Hopson, Michael J Conklin, Jeffrey P Blount
OBJECTIVE Patients with myelomeningocele are often affected by scoliosis and tethered cord syndrome, and frequently require spine surgery. Intradural spine surgeries may carry an inherently higher risk of inducing shunt malfunction due to entry into the subarachnoid space. In this study, the authors sought to compare rates of shunt malfunction after intradural and extradural spine surgeries among pediatric patients with myelomeningocele. METHODS The authors reviewed records of the National Spina Bifida Program Registry for Children's Hospital of Alabama...
October 20, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29017977/syrinx-to-subarachnoid-shunting-for-syringomyelia
#15
Keryn Davidson, Jeffrey M Rogers, Marcus A Stoodley
OBJECTIVE: Surgery for syringomyelia generally aims to treat the underlying cause, if it is known. Optimal management is unclear for idiopathic syringomyelia, or where treatment of the putative cause has failed or is high risk. Syrinx to subarachnoid shunting is an option for these cases; a series is reported to assess the outcomes of this approach. METHODS: We retrospectively analysed the clinical and radiological features of a consecutive series of patients with syringomyelia treated with syrinx to subarachnoid shunting...
October 7, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29016431/incidence-of-congenital-spinal-abnormalities-among-pediatric-patients-and-their-association-with-scoliosis-and-systemic-anomalies
#16
Peter G Passias, Gregory W Poorman, Cyrus M Jalai, Bassel G Diebo, Shaleen Vira, Samantha R Horn, Joseph F Baker, Kartik Shenoy, Saqib Hasan, John Buza, Wesley Bronson, Justin C Paul, Ian Kaye, Norah A Foster, Ryan T Cassilly, Jonathan H Oren, Ronald Moskovich, Breton Line, Cheongeun Oh, Shay Bess, Virginie LaFage, Thomas J Errico
BACKGROUND: Congenital abnormalities when present, according to VACTERL theory, occur nonrandomly with other congenital anomalies. This study estimates the prevalence of congenital spinal anomalies, and their concurrence with other systemic anomalies. METHODS: A retrospective cohort analysis on Health care Cost and Utilization Project's Kids Inpatient Database (KID), years 2000, 2003, 2006, 2009 was performed. ICD-9 coding identified congenital anomalies of the spine and other body systems...
October 9, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28951269/minimally-invasive-excision-of-thoracic-arachnoid-web
#17
Pierluigi Vergara, Damiano Giuseppe Barone
OBJECTIVE: Arachnoid webs are rare intradural lesions that can cause direct spinal cord compression or alteration of the cerebrospinal fluid flow with syringomyelia. Surgery has been historically performed through wide-open laminectomies. The aim of this study is to prove the feasibility of minimally invasive techniques for the excision of arachnoid webs. METHODS: A retrospective review of two cases of minimally invasive excision of thoracic arachnoid webs was performed...
September 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28868301/dynamic-lumbosacral-magnetic-resonance-imaging-in-a-dog-with-tethered-cord-syndrome-with-a-tight-filum-terminale
#18
Steven De Decker, Vicky Watts, David M Neilson
A 1-year and 11-month- old English Cocker Spaniel was evaluated for clinical signs of progressive right pelvic limb lameness and urinary incontinence. Neurological examination was suggestive of a lesion localized to the L4-S3 spinal cord segments. No abnormalities were seen on magnetic resonance imaging (MRI) performed in the dog in dorsal recumbency and the hips in a neutral position and the conus medullaris ended halfway the vertebral body of L7. An MRI of the hips in extended and flexed positions demonstrated minimal displacement of the conus medullaris in the cranial and caudal directions, respectively...
2017: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/28826918/surgical-management-of-142-cases-of-split-cord-malformations-associated-with-osseous-divide
#19
Tao Wang, Jian-Wen Gu, Tie-Jun Shi, Ke Li, Wei Wang, Xiao-Jun Bai, Jun-Hai Zhang, Zhi-Feng Yang, Shao-Jie Cui
OBJECTIVES: To investigate the key surgical points in treating split cord malformations associated with osseous divide and scoliosis (SCM-OD-S). MATERIALS AND METHODS: The surgical options and methods of a total of 142 SCM-OD-S cases were retrospectively analyzed, and the surgical precautions and imaging diagnosis were also discussed. RESULTS: The 142 patients were performed osseous divide resection plus dural sac molding, which achieved good results and no serious complication such as spinal cord and nerve injury occurred; certain symptoms such as urination-defecation disorders, muscle strength subsidence, Pes Cavus, and toe movement disorder in partial patients achieved various degrees of relief, and it also created good conditions for next-step treatment against scoliosis...
August 1, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28817819/progressive-kyphosis-associated-with-tethered-cord-syndrome-treated-by-posterior-vertebral-column-resection-in-a-pediatric-patient
#20
Kadir Oktay, Kerem Mazhar Ozsoy, Yurdal Gezercan, Nuri Eralp Cetinalp, Tahsin Erman
Posterior vertebral column resection is a novel surgical approach for the treatment of progressive kyphosis associated with tethered cord syndrome that was first treated with untethering surgery. A patient with tethered cord syndrome associated with kyphosis first underwent untethering surgery, resulting in progressive kyphosis. Posterior vertebral column resection was performed to correct the kyphosis while shortening the spinal column to prevent the spinal cord from stretch injury. Good correction of kyphosis and reduction of tension on the neural elements were achieved without any neurological deficits...
2017: Pediatric Neurosurgery
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