Related Experiment Video
Updated: Feb 20, 2026
A Neurosphere Assay to Evaluate Endogenous Neural Stem Cell Activation in a Mouse Model of Minimal Spinal Cord Injury
Published on: September 13, 2018
Neurosurgical pathology of limited dorsal myeloschisis
Takato Morioka1, Satoshi O Suzuki2, Nobuya Murakami3
1Department of Neurosurgery, Fukuoka Children's Hospital, 5-1-1 Kashii-teriha, Higashi-ku, Fukuoka, 813-0017, Japan. takato@ns.med.kyushu-u.ac.jp.
Purpose:
The term limited dorsal myeloschisis (LDM) was used by Pang et al. (2010) to describe a distinct clinicopathological entity. LDMs are characterized by two invariable features: a focal-closed neural tube defect and a fibroneural stalk that links the skin lesion to the underlying spinal cord.
Methods:
We retrospectively analyzed the neurosurgical pathologic findings of four LDM patients.
Results:
Case 1 had a saccular skin lesion with nonterminal abortive myelocystocele at T11-12. Cases 2, 3, and 4 had a non-saccular (flat) skin lesion in the lumbosacral region. The morphologic features of the lesion in case 2 were those of meningocele manque. Cases 3 and 4 had accompanying non-LDM anomalies, caudal-type lipoma and type II split-cord malformation with neurenteric cyst, respectively. At preoperative diagnosis of the LDM stalk, magnetic resonance imaging, including 3D heavily T2-weighted image was useful; however, minute findings were often missed in the complicated cases 3 and 4. All patients had a favorable outcome following untethering of the stalk from the cord. The central histopathological feature of the LDM stalk is neuroglial tissue in the fibrocollagenous band; however, the stalk in cases 2 and 4 did not have glial fibrillary acidic protein-immunopositive neuroglial tissues.
Conclusions:
Therefore, the diagnosis of LDM should be made based on comprehensive evaluation of histologic and clinical findings.
Insights
Limited dorsal myeloschisis (LDM) involves a focal-closed neural tube defect linked by a fibroneural stalk. Comprehensive evaluation of histologic and clinical findings is crucial for accurate LDM diagnosis.
Area of Science:
- Neurosurgery
- Pathology
- Developmental Biology
Background:
- Limited dorsal myeloschisis (LDM) is a distinct clinicopathological entity.
- LDMs present with a focal-closed neural tube defect and a fibroneural stalk connecting the skin to the spinal cord.
Observation:
- A retrospective analysis of four LDM patients revealed varied presentations.
- Magnetic resonance imaging aided in diagnosing the LDM stalk, though complex cases posed challenges.
- Histopathological examination of the stalk is key, but neuroglial tissue presence varied.
Findings:
- All patients achieved favorable outcomes after surgical untethering of the stalk.
- The study highlights variability in the histopathological features of the LDM stalk.
- Diagnosis requires integrating both histological and clinical data.
Implications:
- Accurate diagnosis of LDM is essential for appropriate surgical management.
- Further research may clarify the spectrum of LDM and its associated pathologies.
- Understanding LDM's clinicopathological spectrum can improve patient outcomes.
