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Developmental Diseases of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
James H. Tonsgard, Nikolas Mata-Machado
This is the most common form of closed spinal dysraphism. It is characterized by failure of fusion of the vertebral body dorsal to the spinal cord. Radiologic findings in addition to the defect in the posterior vertebral arch may include widening of the spinal canal, fusion of vertebral bodies, and fused or malformed lamina. Abnormalities of overlying skin are common including nevi, dermal sinus, dimple, hemangioma, lipoma, or hair. It commonly involves the lamina of L5 and S1. The incidence is about 5% of the population. When there is any associated neurologic deficit, it is called an occult spinal dysraphism.
Examination abnormalities
Published in Christopher Flannigan, A Practical Guide to Managing Paediatric Problems on the Postnatal Wards, 2017
Spinal dimples are a common finding. In the majority of cases they are simple dimples (<5mm deep in the midline and <25mm from the anus).21 These simple dimples are not associated with any underlying spinal abnormality; no further investigation is necessary and the parents can be reassured that this is a normal variant found in up to 4% of the population.21 However, if the sacral dimple is large (>5mm deep) or located more than 25 mm from the anal verge it may be associated with occult spinal dysraphism.21 The risk of occult spinal dysraphism is also increased by the presence of lumbosacral lipomas, hairy patches, skin tags or vascular lesions.21 The presence of more than one cutaneous lesion overlying the spine significantly increases the risk of occult spinal dysraphism.21
Postoperative complication—No medical history in an ARM patient: Case study
Published in Victoria A. Lane, Richard J. Wood, Carlos A. Reck-Burneo, Marc A. Levitt, Pediatric Colorectal and Pelvic Surgery, 2017
Victoria A. Lane, Richard J. Wood, Carlos A. Reck-Burneo, Marc A. Levitt
Spinal evaluation: Vertebral radiographs to assess for hemivertebrae and scoliosis.Spinal magnetic resonance imaging to assess for occult spinal dysraphism/tethered cord.
Effect of untethering on occult tethered cord syndrome: a systematic review
Published in British Journal of Neurosurgery, 2022
Hamid Rezaee, Ehsan Keykhosravi
During the searching process, 798 articles were selected for the primary assessment; however, 692 of them were extracted due to irrelevancy. Out of the remaining articles, 32 papers were duplicates that were removed, and the rest of the studies were assessed for eligibility. Out of the remaining 74 articles, a total of 13 studies were performed on patients with occult spinal dysraphism and other similar diseases that were excluded from the review. Moreover, a number of other articles were removed due to lack of access to the full-text version (n = 6), insufficient data (n = 2), experimental design (n = 8), animal studies (n = 0), editorial letters, short communications, or brief reports (n = 14), books (n = 1), narrative and review articles (n = 9), and case reports or case series (n = 11). Eventually, 10 reports were found about the clinical outcomes of SFT for the management of OTCS from 1 October to 6 November 2020, which were included in this review.
Congenital Spinal Lipomatous Malformations. Part 1. Spinal Lipomas, Lipomyeloceles, and Lipomyelomeningoceles
Published in Fetal and Pediatric Pathology, 2020
Older terms such as occult spinal dysraphism and spina bifida occulta, often used for congenital spinal lipomatous malformations, provide no additional information to the clinician. Spinal lipoma, lipomyelocele, or lipomyelomeningocele may be the favored all-inclusive term for all congenital spinal lipomatous malformations by clinicians and pathologists, but more precise classification has been called for [4, 21], although unfortunately none has been suggested. Even when clinical distinctions within classifications are straightforward, clinical reports and pathology literature often disregard them [44]. These factors, along with the fact that under the microscope congenital spinal lipomatous malformations have little if any basis for subclassification, make the common names of spinal lipoma, lipomyelocele, and lipomyelomeningocele (as poorly distinguishable as they are in practice) the only terms generally recognized. Furthermore, congenital spinal lipomatous malformations are difficult to classify using terms providing both clinical and pathogenetic information [1, 68]. Clinical classification may rely on embryologic viewpoint, radiological imaging, and intraoperative observations in order to find dissection points and to carry out reconstruction. Pathologists generally follow developmental cues for terminology. Over time, embryologic and surgical viewpoints change [4, 31, 40]. Even arriving at a single, satisfactory group name has been elusive. A local decision on a single term such as spinal lipoma or lipomyelocele to cover the group or terms for denoting subtypes must be arrived at cooperatively.