Surgical treatment for lipomyelomeningocele in children

Huang, Sheng‐Li; Shi, Wei; Zhang, Ligen

doi:10.1007/s12519-010-0210-3

Cited by 34 publications

(26 citation statements)

References 25 publications

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“…49,69 As the subcutaneous lipoma is restricted by the defect in the lumbodorsal fascia, the upward movement of the conus medullaris during axial growth may be limited and thus may lead to progressive neurological and urinary deficits, the sequelae of a tethered cord. 29 Loss of neurological function has been found to increase with age because of progressive conus tethering and injury to nervous tissue. Loss of neurological function has also been demonstrated to have a logarithmic association with increasing patient age and is believed to be secondary to increased stretch on the spinal cord with axial growth spurts.…”

Section: Diagnosis and Presentationmentioning

confidence: 99%

Lipomyelomeningocele: pathology, treatment, and outcomes

Sarris

Tomei²,

Carmel³

et al. 2012

FOC

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Lipomyelomeningocele represents a rare but complex neurological disorder that may present with neurological deterioration secondary to an inherent tethered spinal cord. Radiological testing is beneficial in determining the morphology of the malformation. Specialized testing such as urodynamic studies and neurophysiological testing may be beneficial in assessing for neurological dysfunction secondary to the lipomyelomeningocele. Early surgical intervention may be beneficial in preventing further neurological decline.

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Section: Diagnosis and Presentationmentioning

confidence: 99%

Lipomyelomeningocele: pathology, treatment, and outcomes

Sarris

Tomei²,

Carmel³

et al. 2012

FOC

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“…In addition, other neural tube defects such as spinal bifida, myelomeningocele, lipoma, diastematomyelia, syringomyelus, and sacral canal cyst often accompanied. [4,11–18] In our cases, diastematomyelia and syringomyelus existed in Case 1, and sacral canal cyst existed in Case 3. Similar anesthetic procedure was performed in the cases reported previously.…”

Section: Discussionmentioning

confidence: 46%

Complications after spinal anesthesia in adult tethered cord syndrome

Liu¹,

Zheng²,

Gao³

et al. 2016

Medicine

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Since little has been reported about complications of spinal anesthesia in adult tethered cord syndrome (TCS), we sought to delineate the characteristics of the condition.A total of 4 cases of adult TCS after spinal anesthesia were reviewed. The medical charts of the patients were obtained. Anesthesia, which was combined spinal and epidural anesthesia or spinal anesthesia was performed, and follow-up were carried out in all patients.The most common neurological symptom of adult TCS before surgery was occasional severe pain in back, perineal region, or legs. Frequent micturition, diminished knee and ankle reflexes, and difficulty in bending were exhibited in partial patients. Paraesthesia of perineal region or/and lower extremities existed 2 to 3 days after spinal anesthesia in all the cases. Weakness of lower extremities existed in 1 case. Lumbar magnetic resonance imaging showed the low location of conus medullaris. At follow-up, 3 cases recovered completely within 3 weeks, and 1 case underwent permanent disability.These cases suggest anesthesiologists and surgeons alert to the association of adult TCS and spinal anesthesia. Spinal anesthesia should be prohibited in patients with adult TCS to prevent neurological damages.

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“…[8] performed surgical treatment for 25 children including asymptomatic lipomeningocele in 20 patients. These 20 patients remained symptom-free and three of five symptomatic patients displayed resolution or improvement in symptoms.…”

Section: Discussionmentioning

confidence: 99%

Surgical Outcome of Children and Adolescents with Tethered Cord Syndrome

et al. 2016

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Study DesignRetrospective cohort study.PurposeTo compare long-term results of surgery with the outcomes of symptomatic and asymptomatic tethered cord syndrome (TCS) in children and adolescents and to assess the surgery duration for those with TCS.Overview of LiteraturePediatric patients with TCS continue to pose significant diagnostic and management challenges.MethodsWe retrospectively analyzed the outcomes of 31 patients (16 males, 15 females) with TCS, including 21 with lumbosacral lipoma. All were surgically treated between 1989 and 2015. They were divided into symptomatic and asymptomatic TCS groups. The results of the treatment were summarized and analyzed using a non-parametric Mann–Whitney U test.ResultsNineteen patients had symptomatic TCS and 12 had asymptomatic TCS. Patients had a median age of 34 months (range, 0–201 months). The median follow-up period was 116 months (range, 7–223 months). Of the 19 symptomatic TCS patients, preoperative deficits improved after surgery in two (10.5%) and remained stable in 17 (89.5%) patients. One of the 12 asymptomatic TCS (8.3%) patients showed an exacerbated illness after surgery, and one in 11 patients remained stable (11.7%). There were significant differences in monthly age at surgery, preoperative bowel and bladder dysfunction, neurological function, presence/absence of clean intermittent catheterization introduction, and presence/absence of motor disorder at final follow-up (all p<0.05). In the univariate analysis, the presence/absence of preoperative bowel and bladder dysfunction, and symptoms were strongly associated with the risk of children and adolescents with TCS (p<0.05).ConclusionsEarly accurate diagnosis and adequate surgical release might lead to successful outcomes in children and adolescents with TCS. Surgical untethering is a safe and effective method for treatment of children with TCS.

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Surgical treatment for lipomyelomeningocele in children

Cited by 34 publications

References 25 publications

Lipomyelomeningocele: pathology, treatment, and outcomes

Lipomyelomeningocele: pathology, treatment, and outcomes

Complications after spinal anesthesia in adult tethered cord syndrome

Surgical Outcome of Children and Adolescents with Tethered Cord Syndrome

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