Abstract
The authors report on a series of 26 children with spina bifida occulta in combination with intraspinal lipoma and clinical signs of tethered cord syndrome. The age of the children at presentation ranged from 1 month to 12 years. The typical signs and symptoms consisted of skin lesions in the lumbar-sacral region, neurogenic foot deformities, and bladder and bowel disturbances.
The diagnosis was confirmed by neuroradiological investigations including lumbar myelography, computerized tomography, and only recently magnetic resonance imaging. Indications for surgery were based on the radiological evidence of intraspinal lipoma and tethered cord and especially on the clinical signs of neurological deterioration.
The results of the operative treatment are presented and the role of surgery before onset of symptoms as well as during the symptom-free interval is discussed.
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References
Anderson FM: Occult spinal dysraphism: Diagnosis and treatment. J Pediatr 73 (1968) 163–177
Anderson FM: Occult spinal dysraphism: A series of 73 cases. Pediatrics 55 (1975) 826–835
Bakker-Niezzsen SH, HAP Walder, JL Merx: The tethered spinal cord syndrome. Zeitschr Kinderchir 39 Suppl II (1984) 100–103
Braune M, HP Herberg, M Sörensen: Die Myelographie bei Säuglingen und Kleinkindern mit lumbosakralen Dysraphien. Röntgenpraxis 35 (1982) 221–226
Brickner UM: Spina bifida occulta. Am J M Sc 155 (1918) 473–502
Bode H, M Sauer, HH Strassburg, HJ Gilsbach: Das Tethered-Cord-Syndrom. Klin Pädiat 197 (1985) 409–414
Chapman PC: Occult spinal dysraphism. In:H Schmiedek, WH Sweet: Operative neurosurgical techniques. Vol I, Grune & Stratton Inc., New York 1982
Chapman PH, KR Davis: Surgical treatment of spinal lipomas in childhood. In:AJ Raimondi (ed.): Concepts in pediatric neurosurgery 3. S. Karger, Basel 1983
French BN: Midline fusion defects and defects of formation. In:JR Youmans (ed.): Neurological surgery. 2nd Ed., W. B. Saunders, Philadelphia 1982
Gerlach J, HP Jensen, W Koos, W Kraus: Fehlbildungen des Rückenmarks. Thieme, Stuttgart 1967
Hoffmann HJ, C Taecholarn, EB Hendrick, RP Humphreys: Management of lipomeningioceles. J Neurosurg 62 (1985) 1–8
James CCM, LP Lassmann: Spinal dysraphism. Arch Dis Childh 35 (1960) 315–327
James CCM, LP Lassmann: Spinal dysraphism – The diagnosis and treatment of progressive lesions in spina bifida occulta. J Bone Jt Surg 44b (1962) 828–840
James HEM, RR Laurin, WT Watkins: Remission of pes cavus in surgically treated spinal dysraphism. J Bone Jt Surg A 61 (1979) 1096–1098
Lassmann LP, CCM James: Lumbosacral lipomas: Critical survey of 26 cases submitted to laminectomy. J Neurol Neurosurg Psychiat 30 (1967) 174–181
Lausberg G: Zur Klinik und Differentialdiagnose der Diastematomyelie. Arch Kinderheilk 175 (1966) 14–25
Mavin Padilla M: The tethered cord syndrome: Developmental considerations. In:RN Holtzman, BM Stein (eds.): The tethered spinal cord. Thieme, Stuttgart—New York 1985
Markakis E, H Vogelsang, R Heyer: Neurochirurgisch-neuroradiologische Aspekte der okkulten spinalen Ascensionsstörung im Kindesalter. Aktuelle Neurologie 5 (1978) 253–263
Matthias FR, S Lausberg: Klinik und Differentialdiagnose der cranialen Migrationshemmung des Rükkenmarks. Z. Kinderheilk. 108 (1970) 238–257
Matthias FR, S Lausberg: Diagnosis and therapeutic problems of restriction in cranial migration of spinal cord. Neuropediatric 3 (1972) 339–347
McLone DG, S Mathner, JP Naidich: Lipomeningoceles in the conus medullaris. In:AJ Raimondi (ed.): Concepts in pediatric neurosurgery 3. S. Karger, Basel 1983
Pierre-Kahn A, J Lacombe, J Pichon, Y Giudicelli, D Renier, C Sainte-Rose, M Perrigot, J-F Hirsch: Intrapinal lipomas with spina bifida. J Neurosurg 65 (1986) 756–761
Recklinghausen F v: Untersuchungen über die Spina bifida. Ruiner, Berlin 1886
Till K: Spinal dysraphism: A study of congenital malformations of the back. Develop Med Child Neurol 10 (1968) 470–477
Vogelsang HG: Zur neuroradiologischen Diagnose des fehlenden Rückenmarksascensus. Neuropädiatrie I (1969) 175–186
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Stolke, D., Zumkeller, M. & Seifert, V. Intraspinal lipomas in infancy and childhood causing a tethered cord syndrome. Neurosurg. Rev. 11, 59–65 (1988). https://doi.org/10.1007/BF01795696
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DOI: https://doi.org/10.1007/BF01795696