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Secondary Neurulation Defects-1 : Retained Medullary Cord

Kyung Hyun Kim1, Ji Yeoun Lee1,2, Kyu-Chang Wang1

  • 1Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul, Korea.

Journal of Korean Neurosurgical Society
|April 28, 2020
PubMed

Insights

Retained medullary cord (RMC) is a congenital condition resulting from arrested secondary neurulation. This review clarifies RMC

Area of Science:

  • Neuroscience
  • Developmental Biology
  • Pediatric Surgery

Background:

  • Retained medullary cord (RMC) is a recently defined entity within closed spinal dysraphism.
  • It represents a late arrest of secondary neurulation, resulting in a non-functional cord-like structure at the conus medullaris tip.

Purpose of the Study:

  • To review the existing literature on retained medullary cords.
  • To elucidate the pathoembryogenesis, clinical significance, and treatment of RMCs.

Main Methods:

  • Literature review of retained medullary cord (RMC) cases.
  • Analysis of diagnostic challenges and proposed terminology ('possible RMC').

Main Results:

  • RMC is characterized by a vestigial portion at the conus medullaris tip.
  • Intraoperative electrophysiological confirmation is crucial for definitive diagnosis.
  • Tentative diagnoses are often made preoperatively or with limited surgical exposure.

Conclusions:

  • RMC is a form of closed spinal dysraphism with potential to cause tethered cord syndrome.
  • The term 'possible RMC' is proposed for cases with tentative or assumptive diagnoses.
  • Surgical intervention is indicated for RMCs causing tethered cord syndrome.
Keywords:
Secondary neurulation · Conus medullaris · Intraoperative electrophysiological monitoring · Closed spinal dysraphism · Tethered cord syndrome

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