A rare case of retained medullary cord with sacral subcutaneous meningocele and thoracic arachnoid cyst.

IF 1.2 4区医学 Q4 CLINICAL NEUROLOGY

Child's Nervous System Pub Date : 2025-04-23 DOI:10.1007/s00381-025-06818-0

Mohammed Nadeem, Subhas K Konar, B N Nandeesh, Dhaval Shukla

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引用次数: 0

Abstract

Background: A retained medullary cord (RMC) is an uncommon, closed spinal dysraphism characterized by a robust extended cord-like structure that extends continuously from the conus medullaris to the dural cul-de-sac. There have been six reports of RMC extending to a related sacral subcutaneous meningocele. To the best of authors' knowledge, the combination of retained medullary cord with thoracic arachnoid cyst has never been reported in the literature.

Case presentation: We present a case of the above combination in a 2-year-old child who underwent resection of RMC and fenestration of associated anteriorly placed arachnoid cyst under neuromonitoring. It is prudent to delineate functional and nonfunctional cord segment with neuromonitoring before truncating. The child improved significantly after surgery, and at 1-year follow-up, the child was able to walk with support.

Conclusion: Surgery for RMC involves delineation with neuromonitoring and resection of the nonfunctional cord. Fenestration of the arachnoid cyst must be included in surgical planning, which can be performed as a staged procedure or at same setting.

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保留髓索合并骶骨皮下脑膜膨出及胸椎蛛网膜囊肿一例。

背景：髓索保留（RMC）是一种罕见的闭合性脊柱畸形，其特征是从髓圆锥持续延伸到硬脊膜死囊的坚固延伸的髓索样结构。有6例报道RMC延伸到相关的骶骨皮下脑膜膨出。据作者所知，文献中从未报道过保留髓索合并胸腔蛛网膜囊肿的病例。病例介绍：我们报告了一个2岁儿童的上述联合病例，他在神经监测下切除了RMC并开窗了相关的前置蛛网膜囊肿。在截断前用神经监测来划定功能和非功能的脊髓段是谨慎的。手术后患儿明显改善，随访1年，患儿能够在辅助下行走。结论：RMC的手术包括神经监测和切除无功能脊髓。蛛网膜囊肿的开窗必须包括在手术计划中，可以分阶段进行，也可以在同一环境下进行。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Child's Nervous System 医学-临床神经学

CiteScore

3.00

自引率

7.10%

发文量

322

审稿时长

3 months

期刊介绍： The journal has been expanded to encompass all aspects of pediatric neurosciences concerning the developmental and acquired abnormalities of the nervous system and its coverings, functional disorders, epilepsy, spasticity, basic and clinical neuro-oncology, rehabilitation and trauma. Global pediatric neurosurgery is an additional field of interest that will be considered for publication in the journal.