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Tethered spinal cord

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https://www.readbyqxmd.com/read/28799195/sacral-nerve-stimulation-for-constipation-and-fecal-incontinence-in-children-long-term-outcomes-patient-benefit-and-parent-satisfaction
#1
P L Lu, I J N Koppen, D K Orsagh-Yentis, K Leonhart, E J Ambeba, K J Deans, P C Minneci, S Teich, K A Diefenbach, S A Alpert, M A Benninga, D Yacob, C Di Lorenzo
OBJECTIVE: To evaluate the long-term efficacy of sacral nerve stimulation (SNS) in children with constipation and describe patient benefit and parent satisfaction. METHODS: Using a prospective patient registry, we identified patients <21 years old with constipation treated with SNS for >2 years. We compared symptoms, medical treatment, PedsQL Gastrointestinal Symptom Scale (GSS), Fecal Incontinence Quality of Life Scale (FIQL), and Fecal Incontinence Severity Index (FISI) before SNS and at follow-up...
August 10, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28792087/evaluation-and-management-of-tethered-cord-syndrome-in-occult-spinal-dysraphism-recommendations-from-the-international-children-s-continence-society
#2
REVIEW
Gerald F Tuite, Dominic N P Thompson, Paul F Austin, Stuart B Bauer
AIMS: As awareness and frequency of tethered spinal cord (TSC) related to occult spinal dysraphism (OSD) has increased with magnetic resonance imaging (MRI), variability exists in its evaluation and management. Due to no published level I data, we summarize the current International Children's Continence Society (ICCS) recommendations for diagnosis and treatment of OSD. METHODS: Guidelines were formulated based on analysis of pertinent literature and consensus among authors...
August 9, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28789957/mini-open-spinal-column-shortening-for-the-treatment-of-adult-tethered-cord-syndrome
#3
Michael M Safaee, Ethan A Winkler, Dean Chou
Tethered cord syndrome (TCS) is a challenging entity characterized by adhesions at the caudal spinal cord that prevent upward movement during growth and result in stretching of the cord with a concomitant constellation of neurologic symptoms. Although growth in height stops in adulthood, some patients still develop progressive symptoms; many underwent detethering as a child or adolescent, resulting in significant scar tissue and re-tethering. Recent strategies have focused on spinal column shortening to reduce tension on the spinal cord without exposing the previous de-tethering site...
August 5, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28782691/first-case-of-autonomic-dysrefleixa-following-elective-lower-thoracic-spinal-cord-transection-in-a-spina-bifida-adult
#4
Juanita Garces, Mansour Mathkour, Tyler Scullen, Lora Kahn, Erin Biro, Olawale A R Sulaiman, Roger Smith, Cuong J Bui
BACKGROUND: Spinal cord transection is a radical but effective treatment for highly selective cases of symptomatic spinal re-tethering in paraplegic spina bifida patients. Autonomic dysreflexia (AD) is a potentially life-threatening syndrome involving a dysregulated sympathetic discharge reflex commonly seen following cervical and high thoracic spinal cord injury leading to a disconnect between autonomic pathways above and below the lesion that can lead to severe complications including uncontrolled hypertension, bradycardia, stroke, and potentially death...
August 3, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28695338/management-of-concomitant-scoliosis-and-tethered-cord-syndrome-in-non-spina-bifida-pediatric-population
#5
REVIEW
Kaan Yaltırık, Najib E El Tecle, Matthew J Pierson, Aki Puryear, Basar Atalay, Samer K Elbabaa
BACKGROUND: The management of concomitant scoliosis and tethered cord syndrome in the non-spina bifida pediatric population is challenging. In the present study, we evaluate the efficacy of different treatment modalities and propose a treatment plan for the management of affected patients. METHODS: A systematic literature review was conducted by querying the MEDLINE, PubMed, Cochrane, EMBASE, Scopus, and Web of Science databases for papers published between January 1996 and June 2016 and reporting on concomitant scoliosis and tethered cord...
July 10, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28694236/fibrin-functionalization-with-synthetic-adhesive-ligands-interacting-with-%C3%AE-6%C3%AE-1-integrin-receptor-enhance-neurite-outgrowth-of-embryonic-stem-cell-derived-neural-stem-progenitors
#6
Joana Silva, Ana R Bento, Daniela Barros, Tiago L Laundos, Susana R Sousa, Pedro Quelhas, Mónica M Sousa, Ana P Pêgo, Isabel F Amaral
To enhance fibrin hydrogel affinity towards pluripotent stem cell-derived neural stem/progenitor cells (NSPCs) and its capacity to support NSPC migration and neurite extension, we explored the tethering of synthetic peptides engaging integrin α6β1, a cell receptor enriched in NSPCs. Six α6β1 integrin ligands were tested for their ability to support integrin α6β1-mediated adhesion of embryonic stem cell-derived NSPCs (ES-NSPs) and sustain ES-NSPC viability, migration, and neuronal differentiation. Due to their better performance, peptides T1, HYD1, and A5G81 were immobilized into fibrin and functionalized gels characterized in terms of peptide binding efficiency, structure and viscoelastic properties...
September 1, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28691701/instructing-cells-with-programmable-peptide-dna-hybrids
#7
Ronit Freeman, Nicholas Stephanopoulos, Zaida Álvarez, Jacob A Lewis, Shantanu Sur, Chris M Serrano, Job Boekhoven, Sungsoo S Lee, Samuel I Stupp
The native extracellular matrix is a space in which signals can be displayed dynamically and reversibly, positioned with nanoscale precision, and combined synergistically to control cell function. Here we describe a molecular system that can be programmed to control these three characteristics. In this approach we immobilize peptide-DNA (P-DNA) molecules on a surface through complementary DNA tethers directing cells to adhere and spread reversibly over multiple cycles. The DNA can also serve as a molecular ruler to control the distance-dependent synergy between two peptides...
July 10, 2017: Nature Communications
https://www.readbyqxmd.com/read/28686126/impact-of-magnetic-resonance-imaging-and-urodynamic-studies-on-the-management-of-sacrococcygeal-dimples
#8
Goichiro Tamura, Nobuhito Morota, Satoshi Ihara
OBJECTIVE Sacrococcygeal dimples in neonates and infants are of uncertain pathological import. Previously they were believed to be rarely associated with intraspinal anomalies. Recent studies using MRI, however, revealed that 6%-7% of pediatric cases of sacrococcygeal dimples were associated with anatomical tethered spinal cord (TSC). Because the prevalence of tethered cord syndrome is still unclear, there is no consensus among pediatric neurosurgeons on the management of children with sacrococcygeal dimples...
July 7, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28676974/long-term-evaluation-of-intraoperative-neurophysiological-monitoring-assisted-tethered-cord-surgery
#9
S E Dulfer, G Drost, F Lange, H L Journee, F H Wapstra, E W Hoving
PURPOSE: Patients with tethered spinal cord have been investigated for short-term effects after tethered spinal cord surgery in the past. However, little is known about the long-term effects in this patient group. In this retrospective, longitudinal, observational study, a patient sample of a previous report of 65 patients was reassessed to observe the long-term effects of intraoperative neurophysiological monitoring-assisted tethered cord surgery. METHODS: With the use of patient charts and a survey, patients were scored on four domains: (1) neurological deficits, (2) urological deficits, (3) pain symptoms, and (4) orthopedic deficits...
July 4, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28675347/rare-association-between-spinal-dural-arteriovenous-fistulas-and-dysraphisms-report-of-two-cases-and-review-of-the-literature-with-a-focus-on-pitfalls-in-diagnosis-and-treatment
#10
Talenti Giacomo, Vitale Giovanni, Cester Giacomo, Alessandro Della Puppa, Faggin Roberto, Causin Francesco
Spinal vascular malformations are uncommon yet important spinal pathologies commonly classified in congenital and acquired lesions. Spinal lipomas consist of three subtypes: intramedullary lipomas, lipomyelo(meningo)celes and lipomas of the filum. Although the association of spinal arteriovenous malformations (AVM) with other congenital anomalies is well known, the coexistence of dural arteriovenous fistulas (AVF) and tethered spinal cord is exceptionally rare and only eight cases have been reported. We present two cases from our institution and speculate on the possible origin of such a rare but insidious association...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28674920/tethered-cord-in-patients-affected-by-anorectal-malformations-a-survey-from-the-arm-net-consortium
#11
María Fanjul, I Samuk, P Bagolan, E Leva, C Sloots, C Giné, D Aminoff, P Midrio
PURPOSE: The goal of this study was to determine the degree of consensus in the management of spinal cord tethering (TC) in patients with anorectal malformation (ARM) in a large cohort of European pediatric centers. METHODS: A survey was sent to pediatric surgeons (one per center) members of the ARM-Net Consortium. RESULTS: Twenty-four (86%) from ten different countries completed the survey. Overall prevalence of TC was: 21% unknown, 46% below 15, and 29% between 15 and 30%...
August 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28665387/-treatment-of-syringomyelia-associated-with-adhesive-arachnoiditis
#12
A A Zuev, V B Lebedev, N V Pedyash, D S Epifanov, R S Levin
The prevalence of syringomyelia (SM) caused by adhesive arachnoiditis (AA) is 2 to 4 cases per 100000 population. Surgical treatment of this pathology usually includes implantation of shunts into the cyst cavity or opening and drainage of the cavity. In this case, SM continues to progress in 72-100% of patients. Unsatisfactory outcomes of this surgical approach necessitate searching for other treatment options. PURPOSE: To define the optimal amount of surgery for SM associated with AA and the criteria for assessment of surgery outcomes...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28619063/more-preoperative-flexibility-implies-adequate-neural-pliability-for-curve-correction-without-prophylactic-untethering-in-scoliosis-patients-with-asymptomatic-tethered-spinal-cord-a-retrospective-study
#13
Zhenhai Zhou, Hongqi Zhang, Chaofeng Guo, Honggui Yu, Longjie Wang, Qiang Guo
BACKGROUND: Tethered spinal cord is frequently associated with scoliosis. It is still controversial whether a prophylactic untethering is necessary before correction procedure in scoliosis patients with tethered spinal cord. In this study we determined the clinical outcome of a one-stage posterior scoliosis correction without a prophylactic untethering for treating scoliosis with an asymptomatic tethered spinal cord. METHODS: Seventeen (5 males and 12 females) scoliosis patients with tethered spinal cords were retrospectively reviewed...
June 15, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28614284/cervical-spine-deformities-in-children-with-rhizomelic-chondrodysplasia-punctata
#14
Oussama Abousamra, Vinay Kandula, Angela L Duker, Kenneth J Rogers, Michael B Bober, William G Mackenzie
BACKGROUND: Cervical spine deformity in rhizomelic chondrodysplasia punctata (RCDP) has been described with different findings reported in the literature. However, available literature provides limited data from a few cases with magnetic resonance imaging (MRI) of the cervical spine. Our report describes the MRI findings in a group of children with RCDP, aiming to reach a better understanding of this pathology. METHODS: An Institutional Review Board-approved RCDP Registry was created at our institution with the goal of identifying pertinent medical issues over the lifespan of individuals with RCDP...
June 13, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28598297/the-neuronal-differentiation-microenvironment-is-essential-for-spinal-cord-injury-repair
#15
Yannan Zhao, Zhifeng Xiao, Bing Chen, Jianwu Dai
Spinal cord injury (SCI) often leads to substantial disability due to loss of motor function and sensation below the lesion. Neural stem cells (NSCs) are a promising strategy for SCI repair. However, NSCs rarely differentiate into neurons; they mostly differentiate into astrocytes because of the adverse microenvironment present after SCI. We have shown that myelin-associated inhibitors (MAIs) inhibited neuronal differentiation of NSCs. Given that MAIs activate epidermal growth factor receptor (EGFR) signaling, we used a collagen scaffold-tethered anti-EGFR antibody to attenuate the inhibitory effects of MAIs and create a neuronal differentiation microenvironment for SCI repair...
June 9, 2017: Organogenesis
https://www.readbyqxmd.com/read/28553382/klippel-feil-syndrome-associated-with-sacral-agenesis-low-lying-cord-lipomyelomeningocele-and-split-cord-malformation-presenting-with-tethered-cord-syndrome-pentads-neural-tube-defects-spread-along-whole-spinal-axis
#16
Guru Dutta Satyarthee, Amandeep Kumar
Neural tube defects are congenital development anomaly of the central nervous system and usually have relatively more predilection to affect at anterior and posterior neuropore embryological development sites, so usually one or two defects are commonly encountered. However, occurrence of simultaneous multiple neural tube defects is very rare, presence of constellation of five neural defects is extremely rare, and all defects add up together to produce gross neurological deficit. We present an interesting case of a 23-year-old male who presented with history of lower backache and noticed wasting and weakness of lower limbs associated with difficulty in walking for the last 2 years but had no associated sphincter disturbances...
January 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/28553379/noncontiguous-double-spinal-lipoma-with-tethered-cord-and-polydactyly-two-different-embryological-events-in-one-patient
#17
Shashank Ravindra Ramdurg
Lumbosacral lipoma is reported to occur in 4-8 of 100,000 patients. Sixty-six percent of lipomyelomeningocele in young patients have accompanied by hypertrophic filum terminale. It is rare to find two isolated spinal lipomas simultaneously. Embryological origin of dorsal and filar lipomas is different from each other and hence rarer to find them together. Radical resection is now being preferred for better long-term progression-free survival. We report an interesting case of spinal dysraphism in a 4-month-old female child with protruding, nontender, soft, subcutaneous 5 cm × 7 cm mass of the lumbosacral area that had been present since birth...
January 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/28546867/tethered-cord-syndrome-with-spina-bifida-aperta-in-cats-two-case-reports-of-different-types
#18
Masahiro Tamura, Takashi Oji, Satoshi Une, Makiko Mukaino, Tatsuro Bekki, Masaki Tado, Hiromi Koyama, Yumiko Kagawa, Mutsumi Kawata
CASE SUMMARY: Two castrated male cats, aged 8 months old (case 1) and 10 months old (case 2), showed a history of progressive paraparesis, an over-reaching pelvic limb gait, urinary incontinence and a palpable dermoid fistula. In case 1, the fistula was connected to the dural sac on the conus medullaris, and the tethered spinal cord was retracted caudally. In case 2, the tubular structure was connected to the dural sac on the thoracic spinal cord, and the tethered spinal cord was retracted dorsally...
January 2017: JFMS open reports
https://www.readbyqxmd.com/read/28534605/diastematomyelia-and-late-onset-presentation-a-case-report-of-a-72-year-old-woman
#19
Hanne Maebe, Annick Viaene, Martine DE Muynck
BACKGROUND: We would like to present the case of a 72-year-old woman, in whom diastematomyelia was surprisingly discovered when looking for an explanation for her neurological and urological complaints. Diastematomyelia is a rare disease in the group of 'spinal dysraphisms', mostly discovered at birth and very rare at advanced age. The clinical pattern could be seen in the general presentation of 'tethered cord' and there are 2 types of presentation with a different treatment. CASE REPORT: In our case report the two dominant complaints were pain in the right foot and sphincter problems...
May 23, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28463829/prenatal-sacral-anomalies-leading-to-the-detection-of-associated-spinal-cord-malformations
#20
Baptiste Morel, Stéphanie Friszer, Jean-Marie Jouannic, Hubert Ducou Le Pointe, Eléonore Blondiaux, Catherine Garel
INTRODUCTION: Systematic analysis of the spine is recommended as part of the basic sonographic examination. The aim of our study is to assess the proportion of spinal cord anomalies diagnosed following detection of a sacral anomaly. MATERIAL AND METHODS: We analyzed retrospectively collected data in a prenatal tertiary center during a 9-year period. Patients were referred for second-line ultrasound in the context of diabetes mellitus or following detection of pelvic or lower spine anomalies...
May 3, 2017: Fetal Diagnosis and Therapy
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