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Updated: Jul 15, 2026

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review

Published on: November 8, 2024

Double spinal dysraphism. Report of three cases.

Sepideh Keshavarzi¹, Farideh Nejat, Hadi Kazemi

¹Department of Neurosurgery, Children's Medical Center, Tehran University of Medical Sciences, Iran.

Journal of Neurosurgery

|May 1, 2007

Summary

Multiple spinal neural tube defects, such as double spina bifida cystica, are rare. This study reports three cases, highlighting challenges in understanding neural tube closure mechanisms.

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Area of Science:

Neuroscience
Developmental Biology
Pediatric Surgery

Background:

Spinal neural tube defects (NTDs) are common birth defects.
Simultaneous occurrence of multiple NTDs is exceptionally rare, with limited case reports.
Understanding the embryological basis of NTDs is crucial for diagnosis and management.

Observation:

The study presents three neonates with double spina bifida cystica.
Defect locations varied, including cervical, lumbosacral, thoracolumbar, and sacral regions.
All neonates required surgical intervention, including ventriculoperitoneal (VP) shunt placement for hydrocephalus.

Findings:

Two cases involved double myelomeningoceles (MMCs) at different spinal levels.
One neonate experienced mortality despite a functioning VP shunt.

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Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review

Published on: November 8, 2024

The remaining two neonates had uneventful post-operative recoveries.

Implications:

Existing neural tube closure models inadequately explain multiple spinal dysraphism.
The multisite closure model offers a more comprehensive explanation for caudal NTD development.
Further research is needed to elucidate the pathogenesis of complex spinal NTDs.