Microsurgical repair of lumbar Segmental Myelocystocele and spinal cord Untethering: 2-Dimensional operative video

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience Pub Date : 2025-09-25 DOI:10.1016/j.jocn.2025.111643

Mohammad Elbaroody , Hadie Adams , Muhammad Zubair Tahir

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引用次数: 0

Abstract

Lumbar (non-terminal) myelocystocele is a rare form of closed spinal dysraphism which is characterized by posterior bony defect [[1], [2], [3]], a herniated segment of the spinal cord associated with cystic dilatation of the central canal [[1], [2], [3]], and surrounded by cyst filled with CSF in the subarachnoid space i.e. cyst-within-a-cyst. [[1], [2], [3], [4]] The mass is covered by intact skin and variable amounts of subcutaneous fat which is often attached to neural tissue. [[1], [2], [3]]

Surgery is advocated to untether the cord and reconstruct the neural tube which will prevent further neurological deterioration. [[1], [2], [3]]

In this video, we present the case of a 7-month-old boy who was presented with skin skin-covered lumbar mass after birth. He had left foot drop with no movement in the toes and right foot inversion with associated weakness in the toes. There were no developmental delays and he did not have anorectal anomalies. Magnetic Resonance Imaging (MRI) spine confirmed the diagnosis of lumbar myelocystocele, and urinary flow studies showed good bladder capacity with reasonable voids. The patient underwent spinal cord untethering, neurulation of the neural placode, and duraplasty with an artificial dural graft to increase the cord-sac ratio. [[5], [6], [7]] Postoperative motor power was similar to baseline. The urinary catheter was removed three weeks after surgery with adequate voiding. The were no concerns related to the wound.

The parents consented to the procedure and the publication of the patient’s video. Institutional Review Board approval was not required.

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显微外科修复腰椎节段性髓囊膨出及脊髓解栓：二维手术影像

腰椎（非终末）髓囊性膨出是一种罕见的闭合性脊柱异常，其特征为后部骨缺损[[1]，[2],[3]]，脊髓疝段伴中央椎管囊性扩张[[1]，[2],[3]]，并在蛛网膜下腔被充满CSF的囊肿所包围，即囊肿内囊。[[1],[2],[3]，[4]]肿块被完整的皮肤和不同数量的皮下脂肪覆盖，皮下脂肪通常附着在神经组织上。[[1],[2]，[3]]手术被提倡解开脊髓并重建神经管，这将防止神经系统进一步恶化。[[1],[2]，[3]]在这个视频中，我们介绍了一个7个月大的男孩，他出生后出现了皮肤覆盖的腰部肿块。他左脚下垂，脚趾不活动，右脚内翻，脚趾无力。没有发育迟缓，也没有肛门直肠异常。脊柱磁共振成像（MRI）证实诊断为腰椎囊性膨出，尿流检查显示膀胱容量良好，有合理的空隙。患者接受了脊髓解栓、神经基质神经化和硬脑膜成形术，以人工硬脑膜移植物增加脊髓囊比。[[5],[6]，[7]]术后运动功率与基线相似。术后三周取下导尿管，充分排尿。他们没有担心与伤口有关。患者的父母同意进行手术，并同意公布患者的视频。不需要机构审查委员会的批准。

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

Journal of Clinical Neuroscience 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

402

审稿时长

40 days

期刊介绍： This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.