Myelography of sacral agenesis

Area of Science:

• Neurology
• Pediatric Surgery
• Spinal Cord Imaging

Background:

• Sacral agenesis historically associated with untreatable neurologic deficits.
• Previous assumptions regarding surgical inoperability are challenged by new evidence.

Observation:

• Four pediatric cases of sacral agenesis with detailed myelographic findings presented.
• Surgical interventions were performed and confirmed in three patients.
• Myelographic findings categorized into dural sac stenosis and low-lying spinal cord presentations.

Findings:

• Duraplasty for dural sac stenosis led to significant neurologic improvement in two patients.
• Tethered cord release (filum terminale transection) and arachnoid band lysis improved one infant.
• One patient presented with a low-lying spinal cord and posterior meningocele.

Implications:

• Surgical treatment for dural sac stenosis and tethered cord can significantly improve neurologic function in sacral agenesis.
• Aggressive myelographic assessment and timely surgical intervention are crucial for these pediatric patients.
• Early evaluation and follow-up are essential for optimizing outcomes in children with sacral agenesis.