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Foreign body reactions causing spinal cord tethering: a case-based update.

Juan F Martínez-Lage¹, Belen Ferri Niguez, María José Almagro

¹Regional Service of Neurosurgery, Virgen de la Arrixaca University Hospital, El Palmar, 30120 Murcia, Spain. juanf.martinezlage@cablemurcia.com

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery

|March 12, 2010

Summary

Late functional worsening after spinal surgery for myelomeningocele (MMC) and lipomeningocele (LMC) can occur. This study highlights how foreign materials used in surgery can cause severe scarring and spinal cord tethering.

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Area of Science:

Neurosurgery
Pediatric Surgery
Pathology

Background:

Patients with myelomeningocele (MMC) and lipomeningocele (LMC) may experience delayed functional decline.
Spinal cord tethering due to scarring is a common cause of this worsening.

Observation:

This report details two cases of spinal cord tethering.
Tethering was attributed to foreign body reactions to surgical materials used in primary repairs.
One case involved silk sutures, the other a fibrotic mesh with a dural graft.

Findings:

Histopathology revealed intense foreign body reactions around implanted materials.
These reactions led to significant fibrotic scarring and spinal cord tethering.
No prior literature documented tethering from foreign materials in spinal dysraphism repair.

Implications:

Foreign materials used in initial spinal dysraphism repair can trigger adverse tissue responses.
Minimizing the use of foreign materials in primary repairs is recommended to prevent spinal cord tethering.
This approach may improve long-term functional outcomes for patients.