Filum terminale lipomas: imaging prevalence, natural history, and conus position

Cools, Michael J.; Al-Holou, Wajd N.; Stetler, William R.; Wilson, Thomas J.; Muraszko, Karin M.; Ibrahim, Mohannad; Marca, Frank La; Garton, Hugh; Maher, Cormac O.

doi:10.3171/2014.2.peds13528

Cited by 61 publications

(49 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although this quality improvement initiative did not compare strategies regarding the length of time that patients were kept flat, our finding of a 3.8% (6/160) postoperative CSF leak rate was between the 5.9% rate reported by Chern and colleagues 1 and the 1.9% (1/52) and 0% rates reported by Cools and colleagues 3 and Ogiwara and colleagues, respectively. 7 Both Chern and Ogiwara found that Post = postintervention; Pre = preintervention.…”

Section: Discussionmentioning

confidence: 35%

“…Although many reports detail neurological and urological outcomes following surgical intervention for OSD, [3][4][5][6]9 there is less discussion in the literature regarding perioperative management protocols for variants of OSD that are not associated with substantial tissue defects. 1,7 Because many patients have minimal or no symptoms at the time of operative detethering, the importance of complication avoidance in this population is paramount.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Outcome of hospital discharge on postoperative Day 1 following uncomplicated tethered spinal cord release

Poonia

Graber

Wilkinson

et al. 2016

PED

View full text Add to dashboard Cite

OBJECTIVE Postoperative management following the release of simple spinal cord–tethering lesions is highly variable. As a quality improvement initiative, the authors aimed to determine whether an institutional protocol of discharging patients on postoperative day (POD) 1 was associated with a higher rate of postoperative CSF leaks than the prior protocol of discharge on POD 2. METHODS This was a single-center retrospective review of all children who underwent release of a spinal cord–tethering lesion that was not associated with a substantial fascial or dural defect (i.e., simple spinal cord detethering) during 2 epochs: prior to and following the institution of a protocol for discharge on POD 1. Outcomes included the need for and timing of nonroutine care of the surgical site, including return to the operating room, wound suturing, and nonsurgical evaluation and management. RESULTS Of 169 patients identified, none presented with CSF-related complications prior to discharge. In the preintervention group (n = 113), the postoperative CSF leak rate was 4.4% (5/113). The mean length of stay was 2.3 days. In the postintervention group, the postoperative CSF leak rate was 1.9% (1/53) in the patients with postdischarge follow-up. The mean length of stay in that group was 1.3 days. CONCLUSIONS At a single academic children's hospital, a protocol of discharging patients on POD 1 following uncomplicated release of a simple spinal cord–tethering lesion was not associated with an increased rate of postoperative CSF leaks, relative to the previous protocol. The rates identified are consistent with the existing literature. The authors' practice has changed to discharge on POD 1 in most cases.

show abstract

Section: Discussionmentioning

confidence: 35%

mentioning

confidence: 99%

Outcome of hospital discharge on postoperative Day 1 following uncomplicated tethered spinal cord release

Poonia

Graber

Wilkinson

et al. 2016

PED

View full text Add to dashboard Cite

show abstract

“…These are easily distinguished from more rare DSTs, occurring in approximately 1 in 1500‐2500 live births . Cadaveric studies demonstrate a 4‐6% prevalence of filum terminale lipomas, whereas MRI suggests a prevalence of 0.24‐4% . Spinal cord lipomas are detected in 3‐8/100 000 births .…”

Section: Introductionmentioning

confidence: 99%

Evaluation and management of tethered cord syndrome in occult spinal dysraphism: Recommendations from the international children's continence society

Tuite

Thompson

Austin

et al. 2017

Neurourology and Urodynamics

View full text Add to dashboard Cite

Infants with classic cutaneous markers of OSD, with progressive neurologic, skeletal, and/or urologic findings, present no diagnostic or therapeutic dilemma: they routinely undergo MRI and SCU. Conversely, in asymptomatic patients or those with fixed, minor abnormalities, the risk profile of these OSD cohorts should be carefully considered before SCU is performed. Irrespective of whether or not SCU is performed, patients at risk for progression should be followed carefully throughout childhood and adolescence by a multidisciplinary team.

show abstract

“…A conus position below the inferior margin of the L-2 body is generally considered low-lying at our institution. 6 Patients with syringes that were secondary to spinal tumor, spinal trauma, and other conditions such as infection and spinal arachnoid cyst were also considered separately. Patients were excluded if there was a history of CM Type II or open spinal dysraphism.…”

Section: Following University Of Michigan Institutional Reviewmentioning

confidence: 99%

Syrinx location and size according to etiology: identification of Chiari-associated syrinx

Strahle¹,

Muraszko²,

Garton³

et al. 2015

PED

Self Cite

View full text Add to dashboard Cite

OBJECT Syrinx size and location within the spinal cord may differ based on etiology or associated conditions of the brain and spine. These differences have not been clearly defined. METHODS All patients with a syrinx were identified from 14,118 patients undergoing brain or cervical spine imaging at a single institution over an 11-year interval. Syrinx width, length, and location in the spinal cord were recorded. Patients were grouped according to associated brain and spine conditions including Chiari malformation Type I (CM-I), secondary CM (2°CM), Chiari malformation Type 0 (CM-0), tethered cord, other closed dysraphism, and spinal tumors. Syringes not associated with any known brain or spinal cord condition were considered idiopathic. Syrinx characteristics were compared between groups. RESULTS A total of 271 patients with a syrinx were identified. The most common associated condition was CM-I (occurring in 117 patients [43.2%]), followed by spinal dysraphism (20 [7.4%]), tumor (15 [5.5%]), and tethered cord (13 [4.8%]). Eighty-three patients (30.6%) did not have any associated condition of the brain or spinal cord and their syringes were considered idiopathic. Syringes in patients with CM-I were wide (7.8 ± 3.9 mm) compared with idiopathic syringes (3.9 ± 1.0, p < 0.0001) and those associated with tethered cord (4.2 ± 0.9, p < 0.01). When considering CM-I–associated and idiopathic syringes, the authors found that CM-I–associated syringes were more likely to have their cranial extent in the cervical spine (88%), compared with idiopathic syringes (43%; p < 0.0001). The combination of syrinx width greater than 5 mm and cranial extent in the cervical spine had 99% specificity (95% CI 0.92–0.99) for CM-I–associated syrinx. CONCLUSIONS Syrinx morphology differs according to syrinx etiology. The combination of width greater than 5 mm and cranial extent in the cervical spine is highly specific for CM-I–associated syringes. This may have relevance when determining the clinical significance of syringes in patients with low cerebellar tonsil position.

show abstract

Filum terminale lipomas: imaging prevalence, natural history, and conus position

Cited by 61 publications

References 35 publications

Outcome of hospital discharge on postoperative Day 1 following uncomplicated tethered spinal cord release

Outcome of hospital discharge on postoperative Day 1 following uncomplicated tethered spinal cord release

Evaluation and management of tethered cord syndrome in occult spinal dysraphism: Recommendations from the international children's continence society

Syrinx location and size according to etiology: identification of Chiari-associated syrinx

Contact Info

Product

Resources

About