Neurourological Implications of the Changing Approach in Management of Occult Spinal Lesions

Keating, Michael A.; Rink, Richard C.; Bauer, Stuart B.; Krarup, Christian; Dyro, Frances M.; Winston, Ken R.; Shillito, John; Fischer, E; Retik, Alan B.

doi:10.1016/s0022-5347(17)42030-1

Cited by 109 publications

(56 citation statements)

References 8 publications

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“…Our findings are similar to those reported by Keating et al [13]. They reviewed pre-and postoperative UDS in 28 infants (average age 8.7 months) and 12 older children (average age 11.7 years) with various occult spinal lesions such as lipomeningocele, spinal lipomas, diastematomyelia and thick filum who underwent surgical treatment.…”

Section: Resultssupporting

confidence: 90%

“…Concerned that the tethering effect of the lipomeningocele may lead to impaired spinal cord ascent and mobility, recent authors have recommended early therapy of these lesions [2. 6, 7, 11, 12], Although several studies have documented neurologic function in patients with lipomeningoceles after surgery [2,6,7], the effect of surgery on the urinary tract function has only recently been studied systematically [13]. In this paper, we present our experience with 18 infants with lipomeningocele and evaluate their preoperative and postoperative urodynamic studies (UDS) and neurologic exams.…”

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confidence: 99%

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Effect of Surgical Repair on the Neurourologic Function in Infants with Lipomeningocele

Sathi¹,

Bauer

Scott³

1993

Pediatr Neurosurg

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Eighteen children under the age of 1 year underwent surgery for lipomeningocele at our institution between 1983 and 1991. All the patients had neurologic exams and urodynamic studies (UDS) including a cystometrogram and electromyography of the external urethral spincter pre- and postoperatively. The surgical procedure performed included an untethering of the spinal cord, laser debulking of the lipoma and placement of a dural graft. All the infants presented with a lesion on their back. Two of 10 infants with a normal neurological exam had abnormal UDS preoperatively. Early surgery normalized abnormal preoperative UDS in 5 of 6 (83%) infants with abnormal UDS. Moreover, 3 of 8 (38%) infants with an abnormal neurological exam preoperatively improved after surgery and none worsened. These observations suggest that abnormal urinary tract function in infants with lipomeningocele may be reversible with early prophylactic surgery.

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Section: Resultssupporting

confidence: 90%

mentioning

confidence: 99%

Effect of Surgical Repair on the Neurourologic Function in Infants with Lipomeningocele

Sathi¹,

Bauer

Scott³

1993

Pediatr Neurosurg

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“…76,77 Urologic function may be assessed by history (incontinence, frequency, repeated urinary tract infections), imaging (renal ultrasonography showing hydroureter/hydronephrosis, sometimes with associated small, enlarged, or trabeculated bladder) or by formal urodynamic testing in which the bladder's response to retrograde filling is assessed. 78,79 Urologic manifestations of tethered cord vary according to the age at presentation and the severity of the response to the tethering process. 80,81 More than 90% of children younger than 3 years at diagnosis have no urologic symptoms, and results of formal urodynamic testing at this age are rarely abnormal.…”

Section: Urologic Dysfunction and Dysraphismmentioning

confidence: 99%

“…80,81 More than 90% of children younger than 3 years at diagnosis have no urologic symptoms, and results of formal urodynamic testing at this age are rarely abnormal. 78,82 Urinary tract infection is the predominant sign in an affected infant, but urinary retention is occasionally seen. 77 Once a child is toilet trained, the onset of secondary urinary incontinence, especially in conjunction with fecal incontinence and/or constipation, is the most common presentation of a tethering lesion, although urinary tract infection is still common in this age group as well.…”

Section: Urologic Dysfunction and Dysraphismmentioning

confidence: 99%

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Congenital Brain and Spinal Cord Malformations and Their Associated Cutaneous Markers

Dias

Partington²

2015

Pediatrics

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the SECTION ON NEUROLOGIC SURGERY abstract The brain, spinal cord, and skin are all derived from the embryonic ectoderm; this common derivation leads to a high association between central nervous system dysraphic malformations and abnormalities of the overlying skin. A myelomeningocele is an obvious open malformation, the identification of which is not usually difficult. However, the relationship between congenital spinal cord malformations and other cutaneous malformations, such as dimples, vascular anomalies (including infantile hemangiomata and other vascular malformations), congenital pigmented nevi or other hamartomata, or midline hairy patches may be less obvious but no less important. Pediatricians should be aware of these associations, recognize the cutaneous markers associated with congenital central nervous system malformations, and refer children with such markers to the appropriate specialist in a timely fashion for further evaluation and treatment.

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Prenatal sonographic detection of a lipomeningocele as a sacral lesion

Sharony

Aviram

Tohar

et al. 2000

J. Clin. Ultrasound

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We present a case of a lipomeningocele in a newborn. Prenatal sonography revealed dysraphia and a 3.8 × 4.3 cm, semisolid, echogenic mass that was continuous with the sacral area and bulged posteriorly under the skin. The mass was diagnosed after birth as a lipomeningocele based on the results of MRI. This diagnosis was confirmed histologically. © 2000 John Wiley & Sons, Inc. J Clin Ultrasound 28:150–152, 2000.

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Neurourological Implications of the Changing Approach in Management of Occult Spinal Lesions

Cited by 109 publications

References 8 publications

Effect of Surgical Repair on the Neurourologic Function in Infants with Lipomeningocele

Effect of Surgical Repair on the Neurourologic Function in Infants with Lipomeningocele

Congenital Brain and Spinal Cord Malformations and Their Associated Cutaneous Markers

Prenatal sonographic detection of a lipomeningocele as a sacral lesion

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