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Pre- and post-operative hydromyelia in spinal dysraphism.
James H Scatliff1, Richard Hayward, Diane Armao
1Department of Radiology, School of Medicine, University of North Carolina, 511 Old Infirmary Building, Chapel Hill, NC 27599, USA. jtelle@med.unc.edu
Pediatric Radiology
|October 19, 2004
Summary
Post-operative hydromyelia (fluid-filled cavities in the spinal cord) is common after spinal dysraphism surgery, particularly in diastematomyelia cases. This condition can persist or develop, sometimes correlating with neurological symptoms.
Area of Science:
- Neuroscience
- Radiology
- Pediatric Surgery
Background:
- Limited data exists on post-operative hydromyelia following spinal dysraphism surgery.
- Magnetic Resonance Imaging (MRI) allows for pre- and post-operative assessment of hydromyelia.
Purpose of the Study:
- To describe the incidence and characteristics of hydromyelia after surgery for spinal dysraphism.
- To evaluate the relationship between post-operative hydromyelia and clinical findings over a 7- to 14-year period.
Main Methods:
- Retrospective analysis of 38 patients with congenital lumbar/sacral lipomas and 20 with diastematomyelia.
- Pre- and post-operative 1.5-T MRI scans were performed.
- Clinical correlations were made with imaging findings.
Main Results:
- Hydromyelia was observed in nearly one-third of post-operative lipoma patients and almost half of diastematomyelia patients.
- New or increased hydromyelia occurred in 7 lipoma patients; one developed extensive lumbar hydromyelia.
- In diastematomyelia patients, pre-operative hydromyelia was unchanged in 8, and hemicord hydromyelia developed in 1.
Conclusions:
- Hydromyelia is a frequent finding after spinal dysraphism surgery, especially in diastematomyelia.
- Significant neurological deficits persisted in 7 patients (5 lipoma, 2 diastematomyelia).
- New extensive lumbar hydromyelia may be responsible for symptoms in some post-operative lipoma cases.