Advertisement

Complications of the Occult Spinal Dysraphisms

  • Amy K. Bruzek
  • Cormac O. MaherEmail author
Chapter

Abstract

Patients with occult spinal dysraphisms may develop a variety of different complications as a result of the primary spine anomaly. These secondary complications are diverse and frequently require a multidisciplinary team of healthcare professionals including orthopedic surgeons, urologists, and neurologists, neurosurgeons, physiatrists, therapists, and others in order to achieve the best possible outcomes for affected patients. In this chapter, we outline the most common secondary complications of dysraphisms and describe the presentation and treatment strategy for these conditions.

Keywords

Occult spinal dysraphisms Lipomyelomeningocele Fatty filum Tethered cord Neurogenic bladder 

References

  1. 1.
    Zerah M, Kulkarni AV. Spinal cord malformations. Handb Clin Neurol. 2013;112:975–91.CrossRefGoogle Scholar
  2. 2.
    Cools MJ, Al-Holou WN, Stetler WR, Wilson TJ, Muraszko KM, Ibrahim M, La Marca F, Garton HJL, Maher CO. Filum terminale lipomas: imaging prevalence, natural history, and conus position. J Neurosurg Pediatr. 2014;13:559–67.CrossRefGoogle Scholar
  3. 3.
    Schropp C, Sorenson N, Collmann H, Krauss J. Cutaneous lesions in occult spinal dysraphism – correlation with intraspinal findings. Childs Nerv Syst. 2006;22:125–31.CrossRefGoogle Scholar
  4. 4.
    Guggisberg D, Hadj-Rabia S, Viney C, et al. Skin markers of occult spinal dysraphism in children: a review of 54 cases. Arch Dermatol. 2004;140:1109–15.CrossRefGoogle Scholar
  5. 5.
    Hall DE, Udvarhelyi GB, Altman J. Lumbosacral skin lesions as markers of occult spinal dysraphism. JAMA. 1981;246:2606–8.CrossRefGoogle Scholar
  6. 6.
    McAtee-Smith J, Hebert AA, Rapini RP, Goldberg NS. Skin lesions of the spinal axis and spinal dysraphism. Arch Pediatr Adolesc Med. 1994;148:740–8.CrossRefGoogle Scholar
  7. 7.
    Humphreys RP. Clinical evaluation of cutaneous lesions of the back: spinal signatures that do not go away. Clin Neurosurg. 1996;43:175–87.PubMedGoogle Scholar
  8. 8.
    Kanaheswari Y, Lai CH, Raja Lope RJ, Azizi AB, Zulfiqar MA. Intramedullary spinal cord abscess: the result of a missed congenital dermal sinus. J Paediatr Child Health. 2015;51:223–5.CrossRefGoogle Scholar
  9. 9.
    Gourineni P, Dias L, Blanco R, Muppavarapu S. Orthopaedic deformities associated with lumbosacral spinal lipomas. J Pediatr Orthop. 2009;29(8):932–6.CrossRefGoogle Scholar
  10. 10.
    Thomson JD, Segal LS. Orthopedic management of Spina Bifida. Dev Disabil Res Rev. 2010;16(1):96–103.CrossRefGoogle Scholar
  11. 11.
    Bowman RM, Mohan A, Ito J, et al. Tethered cord release: a long-term study in 114 patients. J Neurosurg Pediatr. 2009;3:181–7.CrossRefGoogle Scholar
  12. 12.
    Torosian CM, Dias LS. Surgical treatment of severe hindfoot valgus by medial displacement osteotomy of the os calcis in children with myelomeningocele. J Pediatr Orthop. 2000;20:226–9.PubMedGoogle Scholar
  13. 13.
    Davids JR, Valadie AL, Ferguson RL, et al. Surgical management of ankle valgus in children: use of a transphyseal medial malleolar screw. J Pediatr Orthop. 1997;17:3–8.PubMedGoogle Scholar
  14. 14.
    Stevens PM, Belle RM. Screw epiphysiodesis for ankle valgus. J Pediatr Orthop. 1997;17:9–12.PubMedGoogle Scholar
  15. 15.
    Balkan E, Kilic N, Avsar I, Boyaci S, Aksoy K, Dogruyol H. Urodynamic findings in the tethered spinal cord: the effect of tethered cord division on lower urinary tract functions. Eur J Pediatr Surg. 2001;11(2):116e9.CrossRefGoogle Scholar
  16. 16.
    Alzahrani A, Alsowayan O, Farmer J-P, Capolicchio J-P, Jednak R, El-Sherbiny M. Comprehensive analysis of the clinical and urodynamic outcomes of secondary tethered spinal cord before and after spinal cord untethering. J Pediatr Urol. 2016;12(5):101.e1–6.CrossRefGoogle Scholar
  17. 17.
    La Marca F, Grant JA, Tomita T, McLone DG. Spinal lipomas in children: outcome of 270 procedures. Pediatr Neurosurg. 1997;26:8–16.CrossRefGoogle Scholar
  18. 18.
    Brown E, Matthes JC, Bazan C 3rd, Jinkins JR. Prevalence of incidental intraspinal lipoma of the lumbosacral spine as determined by MRI. Spine (Phila Pa 1976). 1994;19:833–6.CrossRefGoogle Scholar
  19. 19.
    Bulsara KR, Zomorodi AR, Enterline DS, George TM. The value of magnetic resonance imaging in the evaluation of fatty filum terminale. Neurosurgery. 2004;54:375–9; discussion 379–380.CrossRefGoogle Scholar
  20. 20.
    Uchino A, Mori T, Ohno M. Thickened fatty filum terminale: MR imaging. Neuroradiology. 1991;33:331–3.CrossRefGoogle Scholar
  21. 21.
    Al-Omari MH, Eloqayli HM, Qudseih HM, Al-Shinag MK. Isolated lipoma of filum terminale in adults: MRI findings and clinical correlation. J Med Imaging Radiat Oncol. 2011;55:286–90.CrossRefGoogle Scholar
  22. 22.
    Drake JM. Occult tethered cord syndrome: not an indication for surgery. J Neurosurg. 2006;104:305–8.CrossRefGoogle Scholar
  23. 23.
    Oi S, Sato O, Matsumoto S. Neurological and medico-social problems of spina bifida patients in adolescence and adulthood. Childs Nerv Syst. 1996;12:181–7.CrossRefGoogle Scholar
  24. 24.
    Harrison M, Mitnick R, Rosenblum B, Rothman A. Leptomyelolipoma: analysis of 20 cases. J Neurosurg. 1990;73:360–706.CrossRefGoogle Scholar
  25. 25.
    Hoffman HJ, Hendrick EB, Humphreys RP. The tethered spinal cord: its protean manifestations, diagnosis and surgical correction. Childs Brain. 1976;2(3):145e55.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of NeurosurgeryUniversity of MichiganAnn ArborUSA

Personalised recommendations