Closed Neural Tube Defects: Neurologic, Orthopedic, and Gait Outcomes

Ross, Marilyn; Brewer, Kelly; Wright, Virginia; Agur, Anne

doi:10.1097/pep.0b013e318158cf1e

Cited by 15 publications

(6 citation statements)

References 12 publications

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“…Symptoms tend to be progressive in nature and include pain, sphincter disturbances, sexual dysfunction, distal paralysis and sensory deficits. Neurological deficits have been reported in up to 80% of patients with closed NTD 3 . Signs and symptoms may be present at birth, or may develop later in life.…”

Section: Discussionmentioning

confidence: 99%

“…There are also reported associations, including VACTERL, OEIS (omphalocele, cloacal extrophy, imperforate anus, spinal deformity) and Currarino Syndrome (autosomal dominant condition characterised by partial sacral agenesis, anorectal malformation, and a presacral mass) 7 , 9 , 27 . Partial sacral agenesis is strongly associated with tethered cord syndrome 3 …”

Section: Discussionmentioning

confidence: 99%

“…While open neural tube defects are associated with a poor prognosis, 2 the prognosis (and in particular, the long term prognosis) for other congenital spinal lesions can be difficult to determine. There is also an association between subtle spine lesions and certain multi‐system syndromes 3 …”

Section: Introductionmentioning

confidence: 99%

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A sonographic approach to prenatal classification of congenital spine anomalies

Paoletti

Robertson

Sia

2014

Australas J Ultrason Med

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Objective: To develop a classification system for congenital spine anomalies detected by prenatal ultrasound. Methods: Data were collected from fetuses with spine abnormalities diagnosed in our institution over a five‐year period between June 2005 and June 2010. The ultrasound images were analysed to determine which features were associated with different congenital spine anomalies. Findings of the prenatal ultrasound images were correlated with other prenatal imaging, post mortem findings, post mortem imaging, neonatal imaging, karyotype, and other genetic workup. Data from published case reports of prenatal diagnosis of rare congenital spine anomalies were analysed to provide a comprehensive work. Results: During the study period, eighteen cases of spine abnormalities were diagnosed in 7819 women. The mean gestational age at diagnosis was 18.8w ± 2.2 SD. While most cases represented open NTD, a spectrum of vertebral abnormalities were diagnosed prenatally. These included hemivertebrae, block vertebrae, cleft or butterfly vertebrae, sacral agenesis, and a lipomeningocele. The most sensitive features for diagnosis of a spine abnormality included flaring of the vertebral arch ossification centres, abnormal spine curvature, and short spine length. While reported findings at the time of diagnosis were often conservative, retrospective analysis revealed good correlation with radiographic imaging. 3D imaging was found to be a valuable tool in many settings. Conclusions: Analysis of the study findings showed prenatal ultrasound allowed detection of disruption to the normal appearances of the fetal spine. Using the three features of flaring of the vertebral arch ossification centres, abnormal spine curvature, and short spine length, an algorithm was devised to aid with the diagnosis of spine anomalies for those who perform and report prenatal ultrasound.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A sonographic approach to prenatal classification of congenital spine anomalies

Paoletti

Robertson

Sia

2014

Australas J Ultrason Med

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“…[1,11,12,17,25,26] Retethering results from postoperative dural adhesion. The use of artifi cial dural graft may also prevent from cord retethering.…”

Section: Original Articlementioning

confidence: 99%

Surgical treatment for lipomyelomeningocele in children

2010

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Early operation for LMM patients, even asymptomatic ones, should be performed to prevent the development of neurological deficits. Subtotal excision of lipoma, suturing of the spinal pia mater, and section of the filum terminale are recommended in the surgical treatment of LMM. The longitudinal cut of the filum terminale, a technique we have established in our surgical practice, is a simple and practical way to identify the filum terminale by visual inspection. And suturing the spinal pia mater is of extreme importance in preventing postoperative tethering.

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“…In closed defects there is usually a much lesser involvement of the neural cord with normal brain anatomy and consequently the outcome for these infants is good . However, neurologic symptoms are frequently present and it is important to identify this condition for timely intervention . Lipomyelomeningocele lies within the spectrum of closed neural tube defects and is characterized by a subcutaneous lipoma that is generally located in the lumbar or sacral region and extends through a defect in the lumbodorsal fascial, vertebral neural arch, and dura, attaching to an elongated and tethered spinal cord …”

Section: Introductionmentioning

confidence: 99%

Fetal lipomyelomeningocele: A closed neural tube defect diagnosed at second‐trimester ultrasound examination

Sarmento-Gonçalves

Cunha

Loureiro

et al. 2018

J of Clinical Ultrasound

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Fetal lipomyelomeningocele was suspected during the second-trimester ultrasound and confirmed by magnetic resonance imaging. The pregnancy took its course and a term neonate was delivered. At 2 years of age lipomyelomeningocele surgical removal was performed. The patient is now 4 years old and, despite neurogenic bladder, is a healthy boy with normal psychomotor development for his age. This case illustrates the favorable prognosis of this entity and the importance of prompt diagnosis and multidisciplinary counseling.closed neural tube defect, lipomyelomeningocele, obstetrics, prenatal diagnosis, ultrasound

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Closed Neural Tube Defects: Neurologic, Orthopedic, and Gait Outcomes

Abstract: This classification system has enhanced our knowledge of this group of clients, provided a greater understanding of the varied outcomes of these children and clinical management required.

Cited by 15 publications

References 12 publications

A sonographic approach to prenatal classification of congenital spine anomalies

A sonographic approach to prenatal classification of congenital spine anomalies

Surgical treatment for lipomyelomeningocele in children

Fetal lipomyelomeningocele: A closed neural tube defect diagnosed at second‐trimester ultrasound examination

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