Spinal Cord Anomalies: Spinal Dysraphism

2017 ◽  
Author(s):  
Tamas Fekete
Keyword(s):  
Spinal Cord ◽  
Spinal Dysraphism

Lipomatous Invasion of the Spinal Cord Associated with Spinal Dysraphism

1969 ◽  
Vol 4 (6) ◽  
pp. 405
Author(s):  
Lawrence H. A. Gold ◽  
Stephen A. Kieffer ◽  
Harold O. Peterson
Keyword(s):  
Spinal Cord ◽  
Spinal Dysraphism

Spinal development and spinal dysraphism

2019 ◽  
pp. 983-992
Author(s):  
Dominic Thompson
Keyword(s):  
Spinal Cord ◽  
Spinal Dysraphism ◽  
Radical Resection ◽  
Management Plan ◽  
Congenital Disorders ◽  
Spinal Cord Development ◽  
Precise Diagnosis ◽  
Over Time ◽  
Spinal Cord Tethering

The term spinal dysraphism encompasses a group of congenital disorders of spinal cord development. This potentially confusing array of conditions is best understood from an embryological perspective, and a unifying method of classification is presented. Spinal dysraphism is associated with neurological, urological, and orthopaedic deficits, these may be present at birth or may evolve over time due to the effects of spinal cord tethering. Precise diagnosis is essential to formulating an appropriate surgical management plan in order to optimize long-term neurological outcome. Contemporary and controversial surgical advances in the field are discussed including electrophysiology directed radical resection for spinal lipomas and antenatal surgery for myelomeningocele.

scholarly journals Intradural Lipoma at the Craniocervical Junction Presenting with Progressing Hemiparesis: A Case Report

2019 ◽  
Vol 11 (2) ◽  
pp. 183-188
Author(s):  
Takuro Inoue ◽  
Hisao Hirai ◽  
Ayako Shima ◽  
Fumio Suzuki ◽  
Masayuki Matsuda ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Pediatric Population ◽  
Adult Population ◽  
Spinal Dysraphism ◽  
Craniocervical Junction ◽  
Suboccipital Craniotomy ◽  
Benign Nature ◽  
Intradural Lipoma ◽  
Radiological Studies ◽  
Dorsal Medulla

Intradural spinal lipomas are rare in an adult population. They are mostly asymptomatic and usually associated with spinal dysraphism in a pediatric population. We report a rare case of spinal lipoma without dysraphism and with progressing hemiparesis. A 60-year-old woman had incidental lipoma at the craniocervical junction observed for more than 5 years. Recently, she developed right-sided hemiparesis and sensory disturbance. Radiological studies revealed a large lipoma compressing the dorsal medulla and C1–C2 spinal cord. Standard midline suboccipital craniotomy and C1 laminectomy were performed, and the lipoma was removed subtotally. The lipoma showed severe adhesion to the dorsal medulla and C1 spinal cord; therefore, the excision was limited as internal debulking. Her neurological deficit subsided within 6 months after the decompressive surgery. Considering the benign nature of lipoma, internal decompression is a reasonable management for this lesion.

Spinal Dysraphism and Tethered Spinal Cord

2018 ◽  
pp. 116-132.e2
Author(s):  
Michael C. Dewan ◽  
John C. Wellons
Keyword(s):  
Spinal Cord ◽  
Spinal Dysraphism ◽  
Tethered Spinal Cord

Clinical Indications for Computer-assisted Myelography

Neurosurgery ◽  
1983 ◽  
Vol 12 (1) ◽  
pp. 47-47 ◽  
Author(s):  
Daniel L. Barrow ◽  
James H. Wood ◽  
James C. Hoffman
Keyword(s):  
Spinal Cord ◽  
Pathological Condition ◽  
Spinal Dysraphism ◽  
Intrathecal Administration ◽  
Foramen Magnum ◽  
Pathological Process ◽  
University Hospital ◽  
Primary Study ◽  
Computer Assisted ◽  
Clinical Indications

Abstract Computer-assisted myelography (CAM) is a technique in which computed tomography (CT) is combined with the intrathecal administration of metrizamide to demonstrate the spinal cord and surrounding structures. This retrospective study of 139 CAMs performed at Emory University Hospital included 125 CAMs that were preceded by routine metrizamide myelography (secondary CAM). The remaining 14 CAMs were primary studies without concomitant myelography. These CAMs and conventional myelograms were reviewed to provide indications for the use of CAM as a replacement for other radiodiagnostic studies or as an adjunct to radiological diagnosis. Eighty-one CAMs (58%) were positive for some pathological process. Of the 69 secondary CAMs demonstrating a pathological condition, 46 (67%) revealed some aspect of the lesion not apparent on routine metrizamide myelography. In no case with positive myelography was CAM negative. However, conventional myelography often added valuable diagnostic information. Although high resolution CT has allowed limited visualization of the spinal cord. CAM is often indicated for cases in which diagnosis requires more definition of cervicomedullary, extradural, intradural, extramedullary, and intramedullary lesions. Our clinical review found CAM to be extremely useful in the diagnostic evaluation of pathological conditions involving the spine and spinal cord and suggests clinical indications for the use of CAM based upon selected illustrative cases. Furthermore, CAM seemed to be superior to other radiological procedures in certain instances, such as in cases of spinal dysraphism and in the evaluation of lesions at the foramen magnum. Until more experience is obtained using spinal CT and CAM, CAM should not replace myelography altogether. The present study indicates that, rather than replacing conventional CT and myelography, CAM should be used as a primary study in situations where it has been shown to be superior and as a complementary study when other neurodiagnostic examinations are equivocal or nondiagnostic.

Intramedullary spinal cord lipomas

1995 ◽  
Vol 82 (3) ◽  
pp. 394-400 ◽  
Author(s):  
Mark Lee ◽  
Ali R. Rezai ◽  
Rick Abbott ◽  
Daniel H. Coelho ◽  
Fred J. Epstein
Keyword(s):  
Spinal Cord ◽  
Single Case ◽  
Case Reports ◽  
Spinal Dysraphism ◽  
Neurological Deficits ◽  
Rapid Progression ◽  
Dural Defect ◽  
Intramedullary Spinal Cord ◽  
Presenting Symptoms

✓ Spinal cord lipomas are rare lesions, accounting for approximately 1% of all spinal cord tumors. True intramedullary spinal cord lipomas are extremely rare and are represented in the literature as scattered, single case reports. The authors present a series of six patients with intramedullary spinal cord lipomas managed at our institution from July, 1985 to July, 1993. The patients' ages ranged from 8 to 45 years. Four patients presented with newly diagnosed tumors and two had undergone previous surgery. Patients usually presented with long histories of disability followed by rapid progression of their symptoms. Most patients were in poor neurological condition on presentation. Presenting symptoms included spinal pain, dysesthetic sensory changes, gait difficulties, weakness, and incontinence. Three patients had cervical tumors, two had cervicothoracic tumors, and one patient had a thoracic tumor. Diagnostic studies, including magnetic resonance imaging, were obtained in all patients. No patient exhibited any form of spinal dysraphism or had a dural defect. All patients underwent decompressive, subtotal resections of 40% to 70% of their lesions. Follow-up times ranged from 12 to 96 months. All patients had resolution of their pain, but they generally showed no neurological improvement. As of their most recent follow-up visit, none of the patients was neurologically normal; three can function independently, although with neurological deficits. The other three patients cannot function independently and have severe neurological deficits. The authors conclude that patients with intramedullary spinal cord lipoma who present with significant neurological compromise have a very poor prognosis with regard to neurological function and generally show no improvement with surgical resection.

scholarly journals Intraspinal Neurenteric Cysts in Children

2008 ◽  
Vol 35 (5) ◽  
pp. 609-615 ◽  
Author(s):  
Chunquan Cai ◽  
Changhong Shen ◽  
Weidong Yang ◽  
Qingjiang Zhang ◽  
Xiaoli Hu
Keyword(s):  
Spinal Cord ◽  
Imaging Modality ◽  
Spinal Dysraphism ◽  
Clinical Manifestations ◽  
The Other ◽  
Cervical Region ◽  
Neurological Involvement ◽  
Neurenteric Cyst ◽  
Lumbar Region ◽  
Magnetic Resonance Imaging Mri

Background:Neurenteric cysts are rare congenital epithelium-lined cysts of the central nervous system. They are found predominantly in the spinal cord, with lower incidence in the intracranial compartment, and may be associated with various other congenital spinal anomalies. Seven patients with symptomatic intraspinal neurenteric cysts are presented.Materials and Methods:Seven patients with intraspinal neurenteric cysts aged from nine months to ten years treated at this hospital from May 2000 to July 2006 were reviewed. The clinical manifestations, imaging and surgical findings of patients were analyzed retrospectively. All patients underwent operation. One patient's cervical neurenteric cyst was resected using the lateral cervical approach, and the other six resections were performed with posterior approach.Results:All seven patients presented with neurological involvement. One patient had an intramedullary cyst, while the other six cysts were situated ventrally. Three patients' cysts occurred in the cervical region, two in the cervicothoracic region, one in the thoracic region and one in the lumbar region. One patient had bony anomalies, and one had a lumbar posterior occult spinal dysraphism. Five patients' symptoms improved rapidly after surgery.Conclusions:Intraspinal neurenteric cysts in children are rare and most occur ventral to the spinal cord. Magnetic resonance imaging (MRI) is the most effective imaging modality. Earlier diagnosis and surgical resection of spinal neurenteric cysts improves prognosis.

Terminal syringohydromyelia and occult spinal dysraphism

1994 ◽  
Vol 81 (4) ◽  
pp. 513-519 ◽  
Author(s):  
Bermans J. Iskandar ◽  
Jerry Oakes ◽  
Colleen McLaughlin ◽  
Alan K. Osumi ◽  
Robert D. Tien
Keyword(s):  
Spinal Cord ◽  
Mr Imaging ◽  
Medical Center ◽  
Spinal Dysraphism ◽  
Occult Spinal Dysraphism ◽  
Content Type ◽  
Bowel And Bladder Dysfunction ◽  
Duke University ◽  
Tight Filum Terminale ◽  
Fine Print

✓ Terminal syringohydromyelia is a cystic dilatation of the lower third of the spinal cord. The authors describe its incidence and characteristics, its frequent association with occult spinal dysraphism, and its clinical significance and need for surgical treatment. All 143 cases of occult spinal dysraphism treated at the Duke University Medical Center between 1972 and 1992 were reviewed. A terminal syrinx was found in 24 (27%) of the 90 cases that were evaluated by magnetic resonance (MR) imaging. In contrast, three (6.2%) of 48 cases evaluated by myelography and postmyelographic computerized tomography had a syrinx documented. The relative radiographic severity of the different syringes was estimated by using measurements of the syrinx and spinal cord on the MR images, classifying the cysts into large and small. Large syringes were frequently symptomatic, commonly presenting with pain, motor and sensory deficits of the lower extremities, scoliosis, and bowel and bladder dysfunction. Terminal syringohydromyelia with occult spinal dysraphic lesions was most often associated with tethered spinal cord from a tight filum terminale in the presence of an anorectal anomaly (67% of cases), meningocele manqué (54%), and diastematomyelia (38%). An infrequent association was seen with other spinal cord anomalies. The results of surgical management of terminal syringohydromyelia were analyzed, highlighting the necessity and effectiveness of shunting the large cysts, especially in the setting of a progressive symptomatology. Of the 11 patients with shunts who underwent MR imaging, 10 showed either complete or significant resolution of the syrinx; all five patients who had presented with pain (mainly back pain) showed complete resolution of the pain after shunting; finally, one-third of patients with shunt placement had significant postoperative improvement in their neurological examination, whereas none worsened. It is stressed that terminal syringohydromyelia is an important pathological entity that should be considered in patients with occult spinal dysraphism, and treated surgically when clinically or radiographically significant.

scholarly journals Lumbosacral myelocystocele: A Case report

2014 ◽  
Vol 21 (2) ◽  
pp. 223-226
Author(s):  
R.S. Mittal ◽  
Pankaj Gupta ◽  
Ashok Gandhi ◽  
Achal Sharma ◽  
Vinod Sharma ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Neurological Deficit ◽  
Congenital Anomalies ◽  
Preoperative Diagnosis ◽  
Spinal Dysraphism ◽  
Female Child ◽  
Central Canal ◽  
Uneventful Recovery ◽  
Single Cyst

Abstract Myelocystocele is a rare variety of spinal dysraphism that presents as a skin covered, midline, lumbosacral mass. Many a time it is associated with other congenital anomalies but isolated myelocystocele is rarely associated with neurological deficit. MRI is the modality of choice for preoperative diagnosis. A 3 years old female child presented with skin covered lumbosacral mass since birth. There was no associated neurological deficit. MRI revealed single cyst, which was continuous with central canal of spinal cord. Peroperatively, myelocystocele was found with tethering of cord. Untethering of cord and repair of myelocystocele was performed with uneventful recovery.

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