What Are Cutaneous Lesions Associated with Occult Spinal Dysraphism?

Discussion Neural tube defects are a group of disorders that arise during embryogenesis. They include anenephaly, exencephaly, meningmyelocoeles and encephalocoeles and other malformations including occult spinal dysraphism. Occult spinal dysraphism (OSD) has incomplete fusion of the midline elements of the spine including the bony, neural, and mesenchymal tissues but the abnormalities are covered by skin (ectodermal tissues) and therefore are not obvious. OSD has a higher risk of tethered spinal cord syndrome or other neurological/neurosurgical problems. Normally the caudal end of the spinal cord, the conus medullaris, hangs freely within the spinal column but is stabilized by the filum terminale. As the spinal column grows faster than the spinal cord, there is relative ascension of the conus medullaris during embryogenesis, reaching the adult level from birth to 2 months of age. The adult level is L2 to L3 for 98% of the population. Tethering occurs when a thickened filum terminale or mass does not allow normal ascension and damage to the spinal cord can occur because of ischemia or the mechanical traction. Tethered cord can produce a number of symptoms including bowel or bladder problems, back or leg pain, numbness or tingling, changes in leg strength or gait, muscle spasms, leg deformities, scoliosis, etc. Developmental regression of milestones previously obtained also can occur in children as a sign of tethered cord syndrome. Treatment is by freeing the conus medullaris....
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news