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At least 289 records · Page 16Linked to original sources
PubMed1995

Epidemiology, etiologic factors, and prenatal diagnosis of open spinal dysraphism.

The caudal neural tube closes late in the first month after fertilization and failure of it results in myelomeningocele. Epidemiologic studies have shown differences in prevalence at birth based on ethnic-racial backgrounds and geography. Etiologic factors include the drug valproic acid or carbamazepine. Periconceptional folic acid supplementation appears to decrease the prevalence of neural tube defects. Numerous modalities allow for prenatal diagnosis of myelomeningocele. A cesarean section, before rupture of amniotic membranes and onset of labor, decreases the degree of paralysis.

Cesarean Section↗
PubMed2006

Non-dysraphic intramedullary spinal cord lipoma.

True intramedullary spinal cord lipomas are extremely rare. Two cases of intramedullary spinal cord lipoma are presented. The patients did not exhibit any form of spinal dysraphism. The patients presented with gait difficulty, upper limb weakness, sphincter disturbance, dysesthesias and neck pain. The tumors were removed sub-totally and the neurological grade improved postoperatively in one of the patients.

Adult↗
PubMed1996

Use of the prone position in the MRI evaluation of spinal cord retethering.

In order to determine the impact of magnetic resonance imaging (MRI) in the management of spinal cord retethering, we retrospectively reviewed case and imaging records of 51 patients who underwent MRI examination in supine and prone positions. Group 1 included 8 control patients without cord tethering. They exhibited a normal level of the conus medullaris with normal surrounding subarachnoid space, and consistent anterior migration of the conus within the dural sac on MRI in prone position. Group 2 included 17 patients with tethered cord secondary to occult spinal dysraphism (spinal cord lipoma in 6 patients, thick filum terminale in 4, diastematomyelia in 4, myelomeningocele manqué in 2, and dermoid tumour in 1). Supine and prone MRI performed at a median period of time of 6 months after untethering showed resolution of posterior tethering in 5 out of the 7 patients who exhibited pre-operatively dorsal attachment of the spinal cord to the dura. Anterior migration of the conus or of the cord/filum complex in prone position was observed in only 24% of the cases. Group 3 included 26 patients with secondary tethered cord following prior myelomeningocele closure. Their MRI performed at a median interval of time of 11 months following untethering demonstrated resolution of the posterior cord tethering in only 8 out of the 24 patients who exhibited this feature pre-operatively. Anterior migration within the expanded dural sac was never noted in this group. We conclude that spine MRI is of limited value and that prone-positioned MRI is of no additional use in the evaluation of spinal cord retethering.

Adolescent↗
PubMed2003

Intraspinal extradural teratoma mimicking neural sheath tumor in infant.

INTRODUCTION: An intraspinal teratoma that is located entirely extradurally is unusual both in children and in adults. CASE HISTORY: The authors present a case of an 8-month-old male infant with an extradurally arising intraspinal mature teratoma located from T-2 to T-4, who had suffered from progressive paraparesis (grade 1). The patient did not have any stigmata or anomalies suggesting spinal dysraphism. Spinal MRI showed a cystic extradural mass markedly compressing the dural sac. On operation, the only way of getting sufficient space for exposure of the whole tumor was to perform hemilaminectomies with preservation of facetal areas to prevent postoperative instability. The tumor was well encapsulated and located entirely extradurally, and the cystic portion was occupied with yellowish fluid. The site of tumor occurrence was the spinal root sheath, mimicking a neural sheath tumor. Paraparesis had improved markedly to grade 4 by the time of the neurological examination 3 months after operation.

Epidural Neoplasms↗
PubMed1976

Computed tomography of the spinal canal.

The value of computed tomography (CT) in cases of spinal dysraphism, spinal canal narrowing and widening, and spinal bony abnormalities is discussed. With further experience, CT may become a valuable modality for the diagnosis of spinal diseases.

Humans↗
PubMed1997

The spectrum of spinal cord dysraphism and bladder neuropathy in children.

The frequency of bladder neuropathy and its relationship to abnormalities of the neural axis on MR scan was examined in a group of 49 children with known occult spinal dysraphism and 148 children with daytime urinary incontinence. Of the patients with known spinal dysraphism 55% had bladder neuropathy. There was no relationship between either the type of abnormality or the number of abnormalities seen on MR scan and the presence or absence of bladder neuropathy. 5 of the 9 patients with a normal cord had neuropathic bladders. Four of the 148 patients with daytime wetting turned out to have spinal dysraphism. Of the rest, 51 patients required urodynamic studies and of these 12 had clearcut bladder neuropathy. 15 patients had MR scans, all of which were normal. The range of urodynamic findings in those with bladder neuropathy was identical to the range found in patients with spinal dysraphism. On the basis of these findings it is suggested that children with isolated bladder problems could well have spinal cord dysraphism as a cause of these - the lesions being beyond the resolution of MR scanning. For those children with clearcut spinal dysraphism the absence of any relationship between the bladder findings and the lesion places a question mark over the potential benefits of neurosurgical intervention.

Adolescent↗
PubMed2002

Non-dysraphic intramedullary spinal cord lipoma. A case report.

Non-dysraphic spinal cord lipomas are rare benign lesions, accounting for approximately 1% of all spinal cord tumors. Patients usually present with long histories of disability followed by rapid progression of their symptoms. Presenting symptoms include spinal pain, dysesthesic sensory changes, gait difficulties, weakness, and incontinence. Magnetic resonance imaging is the examination of choice. The T1- and T2-weighted images show increased and decreased signal intensity, respectively. The goal of intervention is decompression and generous debulking following by duraplasty. Early diagnosis of spinal cord lipomas and early surgery is advanced prior to irreversible disease progression. One new case of true non-dysraphic cervicodorsal spinal cord lipoma is reported.

Adult↗
PubMed1983

The tethered spinal cord: diagnosis by high-resolution real-time ultrasound.

High-resolution real-time ultrasonography of the lumbosacral spine was performed in 10 control patients and in six patients with suspected spinal dysraphism. The spinal cord was readily visualized in both groups. Lack of ossification of the posterior arch of the spine in normal infants and the presence of a bony defect in patients with spina bifida permit sonographic investigation of the spinal canal and its contents. It is concluded that the diagnosis of spinal cord tethering can be established rapidly by high-resolution real-time ultrasonography, which may be used in screening patients with suspected occult spinal dysraphism.

Humans↗
PubMed2001

Spinal ultrasound in cloacal exstrophy.

AIM: To assess the diagnostic value of spinal ultrasound in cloacal exstrophy, a caudal malformation which is associated with spinal dysraphism, and to assess the prevalence of spinal dysraphism in cloacal exstrophy. MATERIALS AND METHODS: Ten infants under 1 year old with cloacal exstrophy underwent spinal ultrasound at presentation. Three patients also had a magnetic resonance imaging (MRI) examination. Ultrasound and MRI images were reviewed and correlated. RESULTS: Nine of 10 patients had no external signs of spinal dysraphism. One patient had a clinically apparent myelomeningocele. Five of 10 patients (50%) had spinal dysraphism on ultrasound: there were two patients with a low cord, two with tethered cords and a lipoma, and one patient with tethering and a myelomeningocele. Thus, in four of these five patients spinal dysraphism was occult. In a small number of patients (n = 3) MRI was also performed-in these cases the MRI and ultrasound appearances correlated, however MRI was not performed in those patients in whom spinal ultrasound was normal. CONCLUSION: In three cases where spinal ultrasound detected occult dysraphism and MRI was performed, spinal ultrasound and MRI correlated. Advantages of spinal ultrasound include ease of examination, production of high quality multi-planar images and the facility for portable imaging at the bedside. Spinal ultrasound should be the first investigation in all babies with cloacal exstrophy to diagnose occult and non-occult spinal dysraphism.

Cloaca↗