scholarly journals Spinal lipomas: clinical spectrum, embryology, and treatment

2007 ◽  
Vol 23 (2) ◽  
pp. 1-12 ◽  
Author(s):  
Michael A. Finn ◽  
Marion L. Walker
Keyword(s):  
Surgical Treatment ◽  
Clinical Presentation ◽  
Wide Spectrum ◽  
Spinal Dysraphism ◽  
Treatment Options ◽  
Conus Medullaris ◽  
Clinical Spectrum ◽  
Pathological Features ◽  
Occult Spinal Dysraphism ◽  
Pathological Mechanism

✓Spinal lipomas, particularly lipomas of the conus medullaris and terminal filum, are the most common form of occult spinal dysraphism and represent a wide spectrum of disease with regard to anatomy, clinical presentation, and treatment options. These lesions, however, are united by a similar embryology and pathological mechanism by which symptoms arise. Recently, the treatment of these lesions has generated much controversy, with some physicians advocating surgical treatment for all patients regardless of symptoms and others proposing that surgery be withheld until symptoms develop. The authors discuss lumbosacral spinal lipomas, with particular attention to the theories of their origin, anatomical and pathological features, and treatment options, including a review of current controversies.

Surgical treatment supposed natural history of the tethered cord with occult spinal dysraphism

1997 ◽  
Vol 13 (5) ◽  
pp. 268-274 ◽  
Author(s):  
I. Koyanagi ◽  
Yoshinobu Iwasaki ◽  
Kazutoshi Hida ◽  
Hiroshi Abe ◽  
T. Isu ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Natural History ◽  
Spinal Dysraphism ◽  
Tethered Cord ◽  
Occult Spinal Dysraphism ◽  
History Of

scholarly journals Use of magnetic resonance imaging to detect occult spinal dysraphism in infants

2017 ◽  
Vol 19 (2) ◽  
pp. 217-226 ◽  
Author(s):  
Brent R. O'Neill ◽  
Danielle Gallegos ◽  
Alex Herron ◽  
Claire Palmer ◽  
Nicholas V. Stence ◽  
...  
Keyword(s):  
Congenital Anomalies ◽  
Imaging Modality ◽  
Spinal Dysraphism ◽  
Sinus Tract ◽  
Conus Medullaris ◽  
Dermal Sinus ◽  
Occult Spinal Dysraphism ◽  
Disc Space ◽  
Dermal Sinus Tract ◽  
Study Population

OBJECTIVE Cutaneous stigmata or congenital anomalies often prompt screening for occult spinal dysraphism (OSD) in asymptomatic infants. While a number of studies have examined the results of ultrasonography (US) screening, less is known about the findings when MRI is used as the primary imaging modality. The object of this study was to assess the results of MRI screening for OSD in infants. METHODS The authors undertook a retrospective review of all infants who had undergone MRI of the lumbar spine to screen for OSD over a 6-year period (September 2006–September 2012). All images had been obtained on modern MRI scanners using sequences optimized to detect OSD, which was defined as any fibrolipoma of the filum terminale (FFT), a conus medullaris ending at or below the L2–3 disc space, as well as more complex lesions such as lipomyelomeningocele (LMM). RESULTS Five hundred twenty-two patients with a mean age of 6.2 months at imaging were included in the study. Indications for imaging included isolated dimple in 235 patients (45%), asymmetrically deviated gluteal cleft in 43 (8%), symmetrically deviated (Y-shaped) gluteal cleft in 38 (7%), hemangioma in 28 (5%), other isolated cutaneous stigmata (subcutaneous lipoma, vestigial tail, hairy patch, and dysplastic skin) in 31 (6%), several of the above stigmata in 97 (18%), and congenital anomalies in 50 (10%). Twenty-three percent (122 patients) of the study population had OSD. Lesions in 19% of these 122 patients were complex OSD consisting of LMM, dermal sinus tract extending to the thecal sac, and lipomeningocele. The majority of OSD lesions (99 patients [81%]) were filar abnormalities, a group including FFT and low-lying conus. The rate of OSD ranged from 12% for patients with asymmetrically deviated gluteal crease to 55% for those with other isolated cutaneous stigmata. Isolated midline dimple was the most common indication for imaging. Among this group, 20% (46 of 235) had OSD. There was no difference in the rate of OSD based on dimple location. Those with OSD had a mean dimple position of 15 mm (SD 11.8) above the coccyx. Those without OSD had a mean dimple position of 12.2 mm (SD 19) above the coccyx (p = 0.25). CONCLUSIONS The prevalence of OSD identified with modern high-resolution MRI screening is significantly higher than that reported with US screening, particularly in patients with dimples. The majority of OSD lesions identified are FFT and low conus. The clinical significance of such lesions remains unclear.

scholarly journals Poland’s syndrome

2017 ◽  
Vol 5 (1) ◽  
pp. 63-70
Author(s):  
Olga E. Agranovich ◽  
Igor A. Komolkin ◽  
Alyona Ju. Dimitrieva
Keyword(s):  
Surgical Treatment ◽  
Clinical Features ◽  
Clinical Presentation ◽  
Treatment Options ◽  
The Body ◽  
Poland’S Syndrome ◽  
Poland's Syndrome ◽  
Congenital Condition ◽  
The Right ◽  
Bone Abnormalities

Poland’s syndrome is a rare congenital condition classically characterized by partial or complete absence of chest muscles on one side of the body and usually webbing of the fingers of the hand on the same side. There may also be rib (aplasia or hypoplasia) and chest bone abnormalities, which may be noticeable due to less fat under the skin. Breast and nipple abnormalities may also occur, and underarm hair is sometimes sparse or abnormally placed. In most cases, the abnormalities in the chest area do not cause health problems or affect movement. Poland’s syndrome most often affects the right side of the body and occurs more frequently in males than in females. The etiology is unknown; however, interruption of the embryonic blood supply to the arteries that lie under the collarbone (subclavian arteries) is the prevailing theory. There are many methods of operative correction because of the polymorphic clinical features of this syndrome. We gathered data on the etiology, pathogenesis, and clinical presentation of Poland’s syndrome and reviewed the existing surgical treatment options.

Tethered cord syndrome in children: a review

2007 ◽  
Vol 23 (2) ◽  
pp. 1-9 ◽  
Author(s):  
Cuong J. Bui ◽  
R. Shane Tubbs ◽  
W. Jerry Oakes
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Spinal Dysraphism ◽  
Tethered Cord ◽  
Tethered Cord Syndrome ◽  
Tethered Spinal Cord ◽  
Occult Spinal Dysraphism ◽  
Problematic Issue ◽  
A Minor ◽  
Minor Procedure

✓The treatment of a patient with symptoms of a tethered spinal cord and in whom a fatty infiltrated terminal filum is found is controversial. The authors review their experience and the literature regarding this aspect of occult spinal dysraphism. From experience, transection of a fatty terminal filum in patients with symptoms related to excessive caudal cord tension is a minor procedure that generally yields good results. The most problematic issue in the literature is what patients and symptoms are best suited to surgical treatment.

scholarly journals Management of a Rare Pathology in Children it is Lipomyelomenengocele about Casis Report

2022 ◽  
Vol 11 (1) ◽  
pp. 01-07
Author(s):  
Bouchenaki F ◽  
Habchi N ◽  
Boustil K ◽  
Benachou S ◽  
Bakhti S
Keyword(s):  
Urinary Incontinence ◽  
Surgical Treatment ◽  
Spinal Dysraphism ◽  
Occult Spinal Dysraphism ◽  
Lumbosacral Region ◽  
Postoperative Symptoms ◽  
Single Mass ◽  
Local Examination ◽  
Skin Signs ◽  
Urinary Problems

The lipomyelomeningocele (LMMC) is a type of congenital occult spinal dysraphism consistent with the presence of lipomatous tissue adhering to the epinetic marrow, which falls through a defect of the vertical colon with the former meninges and the marrow under posture the skin. LMMC is the cause of the most frequent congenital attache between the cadre of the syndrome of the attached cord and causes a neurological deterioration due to the compression of the medical bone and the root system which is superadded. It is therefore about a girl from 6 years ago with a swelling located in the region of Lombardy after the birth of the size of a tangerine which has increased the size gradually with age. He presented the interrogation of the signs of urinary incontinence and the fact that he confirmed that he left us to fellow therapists who sent him to us for support. The local examination of the lumbosacral region revealed a single mass without other distinctive skin signs, spherical in shape, 12 × 10 cm, soft and fixed in consistency. A medullary MRI with effect, which reveals a mass of lipomate consistency at the level of lumbosacral associated with a bone spina extending from L5 to S2. Surgical treatment was indicated as the patient had urinary problems. There were no postoperative complications and after a few months postoperative symptoms improved.

scholarly journals TAVI specific sex consideration

2022 ◽  
Author(s):  
Giulia Masiero ◽  
Valeria Paradies ◽  
Anna Franzone ◽  
Barbara Bellini ◽  
Chiara De Biase ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Aortic Stenosis ◽  
Clinical Presentation ◽  
Treatment Options ◽  
Percutaneous Treatment ◽  
Valve Surgery ◽  
Baseline Characteristics ◽  
Aortic Valve Implantation ◽  
Valve Implantation ◽  
The Impact

The impact of sex on baseline characteristics and morphological and clinical presentation of degenerative aortic stenosis has been widely demonstrated but poorly understood. Moreover, differently from valve surgery, where patients were predominantly male, both sexes have been well represented in percutaneous treatment of aortic stenosis (AS), and women appeared to derive greater benefit with transfemoral aortic valve implantation (TAVI) compared to surgical treatment. This review focuses on sex-specific differences in epidemiology, pathophysiology, diagnostic issues, treatment options, and clinical outcomes of degenerative AS. Moreover, we evaluate how sex-based TAVI management, from device selection to procedural tricks, may affect outcomes.

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