scholarly journals A Congenital Defect in the Spinal Cord of the Manx Cat

1971 ◽  
Vol 8 (3) ◽  
pp. 232-238 ◽  
Author(s):  
A. H. Martin
Keyword(s):  
Spinal Cord ◽  
Spina Bifida ◽  
Blood Vessels ◽  
Neural Tissue ◽  
Congenital Defect ◽  
Spina Bifida Occulta ◽  
Incomplete Fusion ◽  
Vascular Defect ◽  
Secondary Mechanism

The lumbar part of the spinal cords of two Manx kittens showed syringomyelia associated with spina bifida occulta. The syringomyelia may have been caused by a secondary mechanism, such as occlusion of blood vessels, that occurred after formation of the spinal cord. There was no apparent hyperplasia of neural tissue. Incomplete fusion of vertebral arches may also have been caused in part by such a vascular defect.

scholarly journals History of the current understanding and management of tethered spinal cord

2016 ◽  
Vol 25 (1) ◽  
pp. 78-87 ◽  
Author(s):  
Sam Safavi-Abbasi ◽  
Timothy B. Mapstone ◽  
Jacob B. Archer ◽  
Christopher Wilson ◽  
Nicholas Theodore ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spina Bifida ◽  
20Th Century ◽  
Surgical Management ◽  
Spinal Dysraphism ◽  
Current Understanding ◽  
Spina Bifida Occulta ◽  
Tethered Spinal Cord ◽  
Modern Management ◽  
Modern Imaging

An understanding of the underlying pathophysiology of tethered cord syndrome (TCS) and modern management strategies have only developed within the past few decades. Current understanding of this entity first began with the understanding and management of spina bifida; this later led to the gradual recognition of spina bifida occulta and the symptoms associated with tethering of the filum terminale. In the 17th century, Dutch anatomists provided the first descriptions and initiated surgical management efforts for spina bifida. In the 19th century, the term “spina bifida occulta” was coined and various presentations of spinal dysraphism were appreciated. The association of urinary, cutaneous, and skeletal abnormalities with spinal dysraphism was recognized in the 20th century. Early in the 20th century, some physicians began to suspect that traction on the conus medullaris caused myelodysplasia-related symptoms and that prophylactic surgical management could prevent the occurrence of clinical manifestations. It was not, however, until later in the 20th century that the term “tethered spinal cord” and the modern management of TCS were introduced. This gradual advancement in understanding at a time before the development of modern imaging modalities illustrates how, over the centuries, anatomists, pathologists, neurologists, and surgeons used clinical examination, a high level of suspicion, and interest in the subtle and overt clinical appearances of spinal dysraphism and TCS to advance understanding of pathophysiology, clinical appearance, and treatment of this entity. With the availability of modern imaging, spinal dysraphism can now be diagnosed and treated as early as the intrauterine stage.

Tethering tracts in spina bifida occulta: revisiting an established nomenclature

2007 ◽  
Vol 7 (3) ◽  
pp. 315-322 ◽  
Author(s):  
Sharad Rajpal ◽  
M. Shahriar Salamat ◽  
R. Shane Tubbs ◽  
David R. Kelly ◽  
W. Jerry Oakes ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spina Bifida ◽  
Dermoid Cyst ◽  
Epithelial Membrane Antigen ◽  
Sinus Tract ◽  
Spina Bifida Occulta ◽  
Dermal Sinus ◽  
Dermal Sinus Tract ◽  
Histological Confirmation ◽  
Sinus Opening

Object The goal of the present study goal was to systematically confirm the previously recognized nomenclature for tethering tracts that are part of the spectrum of occult spinal dysraphic lesions. Methods The tethering tract in 20 patients with spina bifida occulta underwent histological examination with H & E staining and epithelial membrane antigen (EMA) immunolabeling, and additional selected specimens were stained with Masson trichrome. Results All tethering tracts contained fibrous connective tissue. Four tracts were lined with epithelial cells and either originated within a dermoid cyst, terminated at a skin dimple/sinus opening, or had both of these characteristics. No tethering tracts exhibited EMA positivity or meningeal elements. Although all tethering tracts originated in juxtaposition to the spinal cord, their termination sites were variable. Conclusions Based on histological findings and presumed embryological origin, the authors broadly classified tethering tracts terminating within the dura mater, epidural space, or lamina as “short tethering tracts” (STTs). The STTs occurred mostly in conjunction with split cord malformations and had a purely fibrous composition. Tethering tracts terminating superficial to the overlying lamina were classified as “long tethering tracts” (LTTs), and the authors propose that these are embryologically distinct from STTs. The LTTs were of two varieties: epithelial and nonepithelial, the former being typically associated with a skin dimple or spinal cord (epi)dermoid cyst. In fact, analysis of the data suggested that not every tethering tract terminating in or on the skin should be classified as a dermal sinus tract without histological confirmation, and because no evidence of meningeal tissue–lined tracts was detected, the use of the term “meningocele manqué” may not be appropriate.

scholarly journals Surgical Treatment of Neural Tube Defects

2021 ◽  
Author(s):  
Juraj Šutovský
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Spina Bifida ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Neural Tissue ◽  
Prenatal Development ◽  
Nerve Roots ◽  
Live Births

Neural tube defects (NTDs) are developmental pathologies associated with undesirable lifelong consequences. Incidence of these pathologies differs between countries and regions depending on socio-economic and healthcare quality. It is also influenced by folic acid and zinc supplementation. Genetic factors influence probability of NTD, increasing risk of defect in siblings up to 3–8%. Estimated incidence in United States is 3–4/10000 live births, and worldwide incidence increases on about 10/10000 live births. Despite various types and localizations of spina bifida, in all of them neural tissue is in danger. This can lead to various types of neurologic disorders. Not only due to direct damaging of spinal cord and nerve roots but also other parts of central nervous system are also endangered by disturbed prenatal development. Other consequences as orthopedic abnormalities, bladder, and bowel dysfunction influence quality of life. Surgical therapy is often the only possibility to preserve existing function of neural tissue, allows its further development and prevents complications. In this chapter surgical techniques with aim to restore spinal cord and nerve roots anatomy, preservation of its function and defect closures are presented. Also, treatment of possible comorbidities and complications is discussed. Spina bifida management requires multi-speciality cooperation and care to monitor, prevent and treat various potential complication that can negatively influence quality of life and even survival. Prenatal diagnosis is based on maternal screening of serum alpha fetoprotein (AFP) levels and prenatal ultrasonography examination. As the suspicion of neural tube defect arises, an amniocentesis is recommended to complete a genetic analysis and obtain amniotic fluid for more precise AFP and acetylcholinesterase examination. Some types of neural tube defects are diagnosed after delivery, some are symptomatic until adulthood and some are diagnosed incidentally. Each of them requires specific management, based on underlying pathology.

Spina bifida occulta: is it a predictor of underlying spinal cord abnormality in patients with lower urinary tract dysfunction?

2008 ◽  
Vol 1 (2) ◽  
pp. 114-117 ◽  
Author(s):  
Farideh Nejat ◽  
Farid Radmanesh ◽  
Saeed Ansari ◽  
Parvin Tajik ◽  
Abdolmohammad Kajbafzadeh ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Urinary Tract ◽  
Spina Bifida ◽  
Lower Urinary Tract ◽  
Spina Bifida Occulta ◽  
Control Group ◽  
Mr Images ◽  
Significant Difference ◽  
Age And Sex ◽  
Lower Urinary

Object The purpose of this study was to evaluate the importance of spina bifida occulta in radiographs of children with lower urinary tract or bowel dysfunction. Methods The authors prospectively investigated the presence of spinal cord abnormalities in 176 patients with functional urinary and bowel problems: 88 children with radiographic evidence of spina bifida occulta (SBO) and 88 age-and sex-matched controls. Each group included 46 boys and 42 girls (age range 5–14 years). Nocturnal enuresis, isolated diurnal enuresis, enuresis during both day and night, urinary tract infection, urinary frequency, encopresis, intractable constipation, and vesicoureteral reflux were assessed in all patients. Magnetic resonance (MR) images were obtained in all patients and evaluated for spinal cord abnormalities. Sacral ratios (SRs) were calculated on the basis of plain radiographs. Results There was no statistically significant difference between the 2 groups on any of the clinical measures. The most common sites of SBO on radiographs were the S-1 (47%) and L-5 and S-1 (25%). The mean SRs (± standard deviations) in the SBO and control groups, respectively, were 0.64 ± 0.45 and 0.68 ± 0.51 (no statistically significant difference). Sacral agenesis was found in 17 children (7 in the SBO group and 10 in the control group, p = 0.44). Abnormal MR imaging findings were observed in 9 children (10.22%) in the SBO group and 3 (3.4%) in the control group. Abnormalities included tethered spinal cord in 5 children, syringomyelia in 4, and club-shaped conus in 2. No significant association was found between the presence of SBO and spinal cord abnormalities identified on MR images (p = 0.13, paired t-test). Conclusions Among children with functional bowel and urinary problems, there was no statistically significant difference in the prevalence of abnormal spinal MR imaging findings in those with radiographic SBO and an age- and sex-matched control group. Spina bifida occulta was not shown to be a reliable indicator of spinal cord structural abnormalities. Its probable role as a finding associated with spinal cord dysfunction remains unclear.

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