Pseudotail Associated with Spinal Dysraphism

Aso, M.; T, Kawaguchi; Mihara, Miyuki; Shimao, Satoshi; Morimoto, Kyozo; Sakinaga, Yasuo

doi:10.1159/000248980

Cited by 13 publications

(7 citation statements)

References 6 publications

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“…All patients presenting with dorsal midline cutaneous stigmata were evaluated clinically for associated orthopedic spinal and limb deformities, neurologic involvement, and urologic disturbances. Dermatologic conditions ⁄ lesions were defined as per relevant criteria ⁄ definition in the existing literature (1,(3)(4)(5)9,(15)(16)(17)(18)(19)(22)(23)(24)(25)(26)31,36). Patients were evaluated with radiologic investigations to detect underlying SD.…”

Section: Methodsmentioning

confidence: 99%

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A Prospective Study of Cutaneous Manifestations of Spinal Dysraphism from India

Sardana

Gupta

Garg

et al. 2009

Pediatric Dermatology

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Recognition of cutaneous markers of spinal dysraphism is important to prevent the morbidity associated with underlying spinal anomalies. To investigate the frequency and type of cutaneous stigmata in different forms of spinal dysraphism and to assess the role of ultrasonography and/or magnetic resonance imaging in diagnosing spinal dysraphism at two pediatric dermatology tertiary care centers. Over a 4-year period, all pediatric patients presenting to the dermatology clinic with dorsal midline cutaneous stigmata were evaluated clinically and with imaging studies (radiography, ultrasonographic examination and magnetic resonance imaging/Doppler). Surgical interventions were planned in conjunction with neurosurgery and orthopedic specialists. On examination, 245 (4.2%) had 285 cutaneous stigmata. Of the 180 patients evaluated with radiography, ultrasonographic examination and magnetic resonance imaging, 50 patients (28%) had spinal dysraphism (with 64 cutaneous stigmata). The most common stigmata associated with occult spinal dysraphism were lipoma (10) and dimples (12) and in open spinal dysraphism lipomeningomyelocoele (10) and meningomyelocoele (10). Statistically, lipomeningomyelocoele/myelomeningocoele, atypical dimples and port-wine stains were most associated with spinal dysraphism (p < 0.001). In 80 children less than 6 months of age, radiography with ultrasonographic examination revealed an SD in 16, while magnetic resonance imaging was diagnostic in four cases. Ultrasonographic examination performed fairly well in children less than 6 months and in cases of flat cutaneous stigmata it missed only 5% of cases, but in cases with bulky overlying masses (lipoma, hemangioma) it missed 15% of cases.

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Section: Methodsmentioning

confidence: 99%

“…Previous studies have been in various settings: prospective (10), retrospective (17,18), observational (1,4,(19)(20)(21)(22)(23)(24)(25)(26),) or case reports (13,(20)(21)(22)(27)(28)(29)(30)(31)(32)(33)(34)(35). Those from neurosurgery centers (6,7,17,36) report a higher percentage of cutaneous markers associated with SD.…”

mentioning

confidence: 99%

A Prospective Study of Cutaneous Manifestations of Spinal Dysraphism from India

Sardana

Gupta

Garg

et al. 2009

Pediatric Dermatology

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“…It is considered to be a marker of underlying intraspinal pathology of occult spinal dysraphism [2]. A multitude of spinal cord and spine anomalies associations, including spina bifida, lipomeningoceles, myelomeningocele, intraspinal lipoma, spinal cord tethering, and coccygeal vertebrae, were described in patients with human tail [10, 11]. The caudal appendage that mostly occurs with occult spina bifida or spinal dysraphism is pseudotails [2], as described above.…”

Section: Discussionmentioning

confidence: 99%

Unusual Spinal Dysraphic Lesions

Melo

Pacheco

Wanderley

2013

Case Reports in Pediatrics

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Human tail and multiple spinal dysraphism are unusual congenital malformations. Human tail appeared as a prominent lesion from the lumbosacrococcygeal region, generally without connection between the tail and the neurospinal axis. Spinal dysraphisms are usually isolated, reaching 0.038% of incidence of multiple spinal dysraphisms in the same child. There were three cases described of unusual spinal dysraphic lesions: two cases of human tail and a case of a multiple thoracic myelomeningocele. The literature about diagnosis and treatment was reviewed. Microsurgical technique was performed to provide better exploration of the lesions, and resection could be done in those congenital malformations, without morbidity.

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“…There have been many previous reports to date that spinal dysraphism is usually accompanied by several anomalies, including skin protrusion, pigmentation, sinus formation, human tail, and subcutaneous or spinal lipomas [4]. As a consequence, a multitude of spinal cord and spine anomalies associations including spina bifida, meningocele, lipomeningoceles, myelomeningocele, intraspinal lipoma, spinal cord tethering, coccygeal vertebrae have been described in patients with human tail [1, 5–9]. But no report similar to our patient exists in the literature.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of a Patient with Human Tail and Multiple Abnormalities of the Spinal Cord and Column

Cai

Shi

Shen

2011

Advances in Orthopedics

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The dorsal cutaneous appendage, or so-called human tail, is often considered to be a cutaneous marker of underlying occult dysraphism. The authors present a case of human tail occurring in a 9-month-old infant with multiple abnormalities of the spinal cord and spine. Examination revealed unremarkable except for a caudal appendage and a dark pigmentation area in the low back. Neuroradiological scans revealed cleft vertebrae and bifid ribbon, split cord malformations, block vertebrae, and hemivertebra. Surgical excision of the tail and untethering the spinal cord by removal of the septum were performed. The infant had an uneventful postoperative period and was unchanged neurologically for 18 months of followup. To our knowledge, no similar case reports exist in the literature. The specific features in a rare case with a human tail treated surgically are discussed in light of the available literature.

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Pseudotail Associated with Spinal Dysraphism

Cited by 13 publications

References 6 publications

A Prospective Study of Cutaneous Manifestations of Spinal Dysraphism from India

A Prospective Study of Cutaneous Manifestations of Spinal Dysraphism from India

Unusual Spinal Dysraphic Lesions

Surgical Treatment of a Patient with Human Tail and Multiple Abnormalities of the Spinal Cord and Column

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