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Secondary Neurulation Defects: Retained Medullary Cord

Kyung Hyun Kim1,2, Ji Yeoun Lee1,3, Kyu-Chang Wang4,5

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

Advances and Technical Standards in Neurosurgery
|August 28, 2023
PubMed

Insights

Retained medullary cord (RMC) is a neurodevelopmental defect. This review covers RMC

Area of Science:

  • Neuroscience
  • Developmental Biology
  • Spinal Cord Anatomy

Background:

  • Retained medullary cord (RMC) is a rare congenital anomaly.
  • It arises from incomplete secondary neurulation during embryonic development.
  • RMC is characterized by a distinct cord-like structure caudal to the conus medullaris.

Purpose of the Study:

  • To elucidate the embryological mechanisms underlying RMC formation.
  • To describe the diverse morphological presentations of RMC, including cystic variants.
  • To outline current surgical strategies for RMC management, focusing on untethering.

Main Methods:

  • Literature review of RMC pathogenesis and classification.
  • Analysis of intraoperative findings and histological confirmation of RMC.
  • Review of surgical techniques and outcomes for RMC treatment.

Main Results:

  • RMC results from failed regression of the caudal neural tube.
  • Histological analysis confirms neuroglial elements and ependymal lining.
  • Surgical untethering via limited exposure is an effective treatment.

Conclusions:

  • Understanding RMC mechanisms aids in diagnosis and classification.
  • Varied RMC presentations necessitate tailored surgical approaches.
  • Limited exposure untethering offers a viable treatment option for RMC.
Keywords:
Apoptosis arrestRetained medullary cordSecondary neurulationTethered cord

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