Related Experiment Videos
Cervical meningomyelocele--an institutional experience
M K Kasliwal1, S Dwarakanath, A K Mahapatra
1Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi 110029, India.
Objective:
Cervical myelomeningoceles (CMMC) are a less common but distinct subgroup of myelomeningoceles. Their embryology and clinical characteristics vary from the more common thoracolumbar variant. Only a few small series have been published addressing this lesion in the literature with the largest one of them addressing nine patients. The authors present one of the largest series of cervical myelomeningoceles, review their embryology, clinical features, and their management strategies.
Methods:
This study included all the children who were managed for cervical myelomeningocele between Jan 2001 to July 2006 at our center.
Results:
There were a total of ten children (five boys and five girls) operated on for cervical myelomeningoceles. The ages ranged between 2 months to 14 months. Neurological examination was normal in majority of the children with absence of gross orthopedic deformity in all the children. Three patients had associated hydrocephalus, two had Chiari malformation, and four of them had a syrinx. Surgical excision of the sac was performed for all.
Conclusion:
Cystic dysraphisms of the cervical differ embryologically, clinically, and structurally from thoracolumbar meningomyelocele and have a more favorable outcome. A good pre operative evaluation is recommended to assess any associated anomalies and identify the internal structures. Surgery excision of these lesions with intradural exploration of the sac to release any potential adhesion bands as well as other associated anomalies is recommended.
Insights
Cervical myelomeningoceles (CMMC) present differently than thoracolumbar types, with a more favorable outcome. Early evaluation and surgical excision are recommended for optimal management of these distinct spinal defects.
Area of Science:
- Pediatric Neurosurgery
- Spinal Dysraphism Research
- Congenital Malformations
Background:
- Cervical myelomeningoceles (CMMC) are a rare subgroup of spinal dysraphism.
- They exhibit distinct embryological and clinical features compared to thoracolumbar variants.
- Limited data exists, with few small case series published.
Purpose of the Study:
- To present one of the largest series of CMMC cases.
- To review the embryology, clinical characteristics, and management of CMMC.
- To compare CMMC with thoracolumbar meningomyelocele.
Main Methods:
- Retrospective review of pediatric patients managed for CMMC.
- Study period: January 2001 to July 2006.
- Surgical excision of the sac was the primary intervention.
Main Results:
- Ten children (5 boys, 5 girls) aged 2-14 months underwent surgery for CMMC.
- Most patients had normal neurological exams and no gross orthopedic deformities.
- Associated anomalies included hydrocephalus (3), Chiari malformation (2), and syrinx (4).
Conclusions:
- Cervical myelomeningoceles are embryologically and clinically distinct from thoracolumbar lesions.
- CMMC demonstrate a more favorable prognosis.
- Preoperative evaluation for associated anomalies and surgical excision with intradural exploration are recommended.
Related Concept Videos
01:19Cranial and Spinal Meninges
Cranial Meninges
These meningeal layers cover the cranium. The dura mater is the outermost layer of cranial meninges. It is a thick and durable membrane of dense...
01:22Bacterial Meningitis I: Introduction