Background: Tethered spinal cord syndrome (TCS) can occur after the surgical repair of lipomeningoceles (LMCs). In these cases, the tethering results from postoperative adhesions between the spinal cord and the overlying repaired dura. A watertight dural closure using the residual dura and/or the surrounding tissues does not always provide enough space for the spinal cord and risks retethering. Here, we report a 16-year-old patient with secondary TCS following lipomeningocele repair who successfully underwent release of the tethered filum terminale utilizing a novel dural splitting reconstructive technique to attain a water-tight closure without the need for a duroplasty.
Methods: A 16-year-old patient had a LMC repaired at birth. She now presented with progressive low back pain, and gait disturbances. The MRI documented secondary spinal cord tethering at the prior spinal dysraphism repair site.
Results: A secondary release of the filum terminale utilizing a novel dural splitting technique to avoid the need for a duroplasty was performed.
Conclusion: Here, in a 16-year-old patient with a recurrent tethered cord syndrome following repair of a LMC at birth, we utilized a novel dural splitting reconstruction technique and averted the need for a duroplasty.
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http://dx.doi.org/10.25259/SNI_734_2021 | DOI Listing |
Surg Neurol Int
November 2024
Department of Neurosurgery, Hannover Medical School, Hannover, Germany.
Background: This study aims to evaluate the surgical outcomes of elderly patients with Chiari malformation (CM) who underwent suboccipital craniectomy (SC) with duraplasty (DP) or dural splitting (DS). The focus is on symptom relief, changes in syrinx size, hospital admission duration, and postoperative complications.
Methods: A retrospective study was performed to evaluate the outcomes of elderly CM patients who underwent SC with DP or dural splitting (DS).
World Neurosurg
November 2024
Department of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
Objective: Among several procedures for syringomyelia associated with Chiari type 1 malformation (CM-1), foramen magnum decompression (FMD) with dural splitting is one of the treatment choices with low complication rates. However, some meta-analyses have suggested that FMD with dural splitting may be inferior to FMD with duraplasty based on clinical outcomes; therefore, a predictor of a good surgical outcome with dural splitting is essential. This study aimed to clarify the preoperative parameters for good outcomes in patients with FMD with dural splitting, including the volumetric perspective.
View Article and Find Full Text PDFScars Burn Heal
September 2024
Plastic Surgery & Burns Department, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Background: Myelomeningocele is a severe and complex congenital malformation of the central nervous system. Failure of neural tube closure at around four weeks of gestation results in an open communication between the neural placode and the external environment with varied functional impairment. Surgery is usually required.
View Article and Find Full Text PDFChilds Nerv Syst
November 2024
Head of the Department Neurosurgery, Byramjee Jeejeebhoy Medical College & Civil Hospital, Ahmedabad, Gujarat, India.
The primary purpose of this study was to enhance the understanding of diastematomyelia, with a particular focus on adult-onset cases, which are infrequent and not fully elucidated. Additionally, the study sought to analyse the clinical features, diagnostic characteristics, and surgical interventions employed to manage the condition. This retrospective case series aimed to investigate diastematomyelia, a rare congenital deformation affecting the spinal cord.
View Article and Find Full Text PDFJ Orthop Surg Res
April 2024
Orthopedics of TCM Senior Department, The Sixth Medical Center of PLA General Hospital, 6 Fucheng Road, Haidian District, Beijing, 100048, People's Republic of China.
Background: The one-hole split endoscopy (OSE) was first proposed and clinically applied in China in 2019. The aim of this study was to compare the clinical efficacy of one-hole split endoscopy (OSE) and unilateral biportal endoscopy (UBE) for treating lumbar spinal stenosis (LSS).
Methods: One hundred sixty patients with LSS who met the inclusion from November 2020 to August 2022 were analyzed and divided into OSE and UBE groups.
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