Aim: Occult spinal dysraphism, which manifests with motor and sensory disturbances in children and causes orthopedic deformities in the lower extremities and urological findings, is the result of developmental defects in the caudal part of the neural tube. One of the most common spinal dysraphism is tethered cord syndrome (TCS). In this study, patients who had been diagnosed with TCS in the past 5 years were retrospectively reviewed and clinical, radiological and surgical characteristics of these patients were tried to be revealed. Material and Methods:We retrospectively reviewed the data about 26 patients with the diagnosis of TCS in our clinic between 2011-2015. The results of these surgeries were evaluated by age, gender, additional malformations, clinic symptoms, radiological and electrophysiological evaluation. The patient with urological symptoms was additionally performed in urodynamic tests. Results: These 26 cases, 23% were children and 77% were adults. 81% of the patients were male and 19% female. Only 3.8% of the patients were primary TCS, 96.2% of the patients had other malformations. Urine incontinence was found in 19.2% of the patients and orthopedic deformities were found in 7.7% of the patients. Surgical treatment was done to 65% of the patients, and 35% of the patients were followed because they didn't want to be operated. Conclusion: Tethered cord syndrome is usually not seem alone, it is associated with other developmental defects of the spine and spinal cord. If surgery done earlier, the greater the likelihood of regression of the neurological deficit or stablization the deficits.
Amaç: Bu çalışmanın amacı pterionun morfometrik özelliklerini ve pterionun iç yüzeyini, komşu anatomik yapılar için yapılan cerrahi prosedürler açısından değerlendirmektir. Yöntemler: Çalışmaya, iskelet gelişimi tamamlamış 35 kafatası dahil edildi. Kafataslarından 15'i kadavralara aitti, 20 tanesi kuru kemik idi. Tüm örnekler anatomi anabilim dalından alınmıştır. Pterion tipi ve pterionun orta noktasının palpabl yüzey işaret noktalarına olan uzaklığı kaydedildi. Pterionun iç yüzeyi, bir lazer işaretçinin translüminasyonu ile işaretlenmiştir. Pterionun önemli anatomik yapılarla örtüşmesi ve onlara olan en yakın mesafesi değerlendirildi. Bulgular: Pterionun en yaygın görülen tipi sphenoparietal tip (%80), en az gözlemlenen tipi epipterik tip pterion (%1,4) idi. Kalvaria'nın pterion üzerindeki ortalama kalınlığı 4,2±0,16 mm olarak ölçüldü. Pterion, arcus zygomaticus'un orta noktasına göre yaklaşık 4 cm üstte ve 2,5 cm önde; tuberculum marginale'ye göre 3 cm üstte ve 1,5 cm arkada, processus mastoideus'a göre 7 cm üstte ve 6,5 cm önde yer alıyor olarak bulunmuştur. Örneklerin %61,4'ünde (n=43) pterionun iç yüzeyi a. meningea media'nın oluğu ile ilişkili bulunmuştur. Örneklerin %81,4'ünde (n=57) ise sinüs sphenoparietalis ile çakışmaktaydı. Foramen spinosum posteroinferior yerleşimde ve ortalama en yakın mesafesi 39,8±6,53 mm idi. Meckel oluğu posteromedial yerleşimde ve ortalama en yakın mesafe 40,6±3,18 mm idi. Sonuç: Sinüs sphenoparietalis ve a. meingea media'nın frontal dalı, pterionun iç yüzeyi ile çakışan başlıca anatomik yapılardır. Objective: Aim of this study was to evaluate the morphometric features and the inner surface of the pterion in terms of surgical procedures for neighboring anatomical structures. Methods: Thirty five skeletally mature craniums were included in the present study. Fifteen of the craniums were belonged to cadavers, 20 of the craniums were dry bones. All specimens were obtained from the department of anatomy. Type of pterion and distance of midpoint of pterion to palpable surface landmarks were noted. Inner surface of pterion was marked by translumination of a laser pointer. Overlap of pterion with important anatomical structures and its closest distance to them was evaluated. Results: The most common type of pterion was sphenoparietaltype (80%) and the least common type was epipterical (1.4%) type. The mean thickness of the calvaria on the pterion was 4.2±016 mm. Pterion is located approximately 4 cm superior and 2.5 cm anterior to midpoint of arcus zygomaticus; 3 cm superior and 1.5 cm posterior to tuberculum marginale; 7 cm superior and 6.5 cm anterior to the tip of processus mastoideus. In 61.4% (n=43) of samples, inner surface of pterion was found to be associated with groove of a. meningea media. In 81.4% (n=57) of specimens, inner projection was coincided with sinus sphenoparietalis. Foramen spinosum was located posteroinferior to inner projection and the mean closest distance was 39.8±6.53 mm. Meckel cave was located posteromedial to inner projection and the mean closest distanc...
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