Urological Outcome of the Xiao Procedure in Children with Myelomeningocele and Lipomyelomeningocele Undergoing Spinal Cord Detethering.

Purpose: Although previous studies have revealed high success rates (70% to 85%) after an intradural somatic-to-autonomic nerve transfer procedure in children with spinal dysraphism, no study has had a control group or blinded observers. We report a rigorously designed study to investigate the effectiveness of the Xiao procedure.

Materials And Methods: Children with neurogenic bladder dysfunction related to myelomeningocele or lipomyelomeningocele who required spinal cord detethering were randomized to 2 groups at surgery, with half undergoing only spinal cord detethering and half undergoing the Xiao procedure in addition to detethering.

Lack of efficacy of an intradural somatic-to-autonomic nerve anastomosis (Xiao procedure) for bladder control in children with myelomeningocele and lipomyelomeningocele: results of a prospective, randomized, double-blind study.

OBJECTIVE Xiao et al. and other investigators have studied an intradural somatic-to-autonomic (e.g.

Angiography-negative primary angiitis of the central nervous system in childhood.

Childhood primary angiitis of the CNS is a recently characterized, potentially reversible disease process. A favorable outcome requires early diagnosis and appropriate treatment. The histological findings of childhood primary angiitis of the CNS are characterized by a lymphocytic, nongranulomatous vasculitis.

Attempted bladder reinnervation and creation of a scratch reflex for bladder emptying through a somatic-to-autonomic intradural anastomosis.

An intradural somatic-to-autonomic anastomosis, or Xiao procedure, has been described to create a "skin-CNS-bladder" reflex that improves bladder and bowel function in patients with neurogenic bladder and bowel dysfunction. The authors present their experience with a 10-year-old boy with chronic neurogenic bladder and bowel dysfunction related to spinal cord injury who underwent the Xiao procedure. After undergoing a left L-5 ventral root to left S2-3 intradural anastomosis, the patient reported that his bladder and bowel dysfunction improved between 6 and 12 months.

The use of transcutaneous thermal convection analysis to assess shunt function in the pediatric population.

Background: The diagnosis of shunt malfunction is largely made by subjective clinical history and assessment in association with neurodiagnostic imaging.

Objective: : To evaluate the use of a transcutaneous thermal convection device for the diagnosis of shunt malfunction.

Methods: We present the results of a trial of a commercially available device under an Institutional Review Board-approved protocol.

Congenital dermoid tumor in a child at initial myelomeningocele closure: an etiological discussion.

The authors report on a case of a full-term infant with lumbar myelomeningocele who was found to have an intramedullary mass at the time of surgical repair of the defect. The intramedullary mass was consistent with a dermoid tumor both macroscopically and microscopically. This case provides evidence that dermoid tumors occurring at the site of previous surgical myelomeningocele repair are not always a consequence of incomplete excision of the dermal elements.

Primary closure of open myelomeningocele.

Object: The purpose of this paper is to describe the technique of closing an open myelomeningocele in the newborn infant.

Methods: The anatomical rationale behind the closure techniques will be specifically reviewed. Avoidance of complications will be discussed.