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[Intraspinal lipoma with tethered cord syndrome in childhood]
M B Zumkeller1, V Seifert, D Stolke
1Neurochirurgische Klinik, Medizinische Hochschule Hannover.
Insights
This study examines 26 children with spina bifida occulta and intraspinal lipoma, highlighting key symptoms like skin changes and bladder dysfunction. Surgical intervention is discussed for tethered cord syndrome to prevent neurological decline.
Area of Science:
- Pediatric Neurosurgery
- Spinal Dysraphism Research
- Congenital Neurological Disorders
Context:
- Focuses on a cohort of 26 pediatric patients diagnosed with spina bifida occulta co-occurring with intraspinal lipoma.
- Addresses the clinical manifestations and diagnostic challenges associated with tethered cord syndrome in children.
- Highlights the spectrum of symptoms, including dermatological, orthopedic, and genitourinary issues.
Purpose:
- To analyze the clinical presentation, diagnostic methods, and surgical outcomes in children with spina bifida occulta and intraspinal lipoma.
- To evaluate the effectiveness of surgical intervention for tethered cord syndrome in this specific pediatric population.
- To discuss the optimal timing for surgical treatment, considering both symptomatic and asymptomatic cases.
Summary:
- The study details 26 children (1 month to 12 years) presenting with spina bifida occulta, intraspinal lipoma, and tethered cord syndrome.
- Common symptoms included lumbosacral dermatological changes, neurogenic foot deformities, and bladder dysfunction.
- Diagnosis utilized advanced neuroradiological techniques such as MRI, CT, and myelography, with surgical indications based on imaging and neurological status.
Impact:
- Provides insights into the management of a complex spinal anomaly in pediatric patients.
- Emphasizes the importance of early diagnosis and surgical intervention to mitigate neurological deterioration.
- Contributes to the understanding of surgical timing and outcomes for tethered cord syndrome associated with intraspinal lipoma.
Abstract:
In this article the authors report on a series of 26 children with spina bifida occulta in combination with intraspinal lipoma and clinical signs of tethered cord syndrome. The age of the children at presentation ranged from 1 month to 12 years. The typical signs and symptoms of the patients consisted of dermatological changes in the lumbosacral region, neurogenic foot deformities and genitourinary tract anomalies with disturbed bladder function. The diagnosis was confirmed by neuroradiological studies including lumbal myelography, spinal computerized tomography and only recently magnetic resonance imaging. Indications for surgery were based on the radiological evidence of intraspinal lipoma and tethered cord and especially on the clinical signs of neurological deterioration. The results of the operative treatment are presented and the role of surgery before onset of symptoms as well as during the symptom-free interval are discussed.