Is repair of the protruded meninges sufficient for treatment of meningocele?

Abstract

PURPOSE:

The present study aimed to investigate the relationship between meningocele and tethered cord syndrome, diagnosis of meningocele associated with tethered cord syndrome, and when to perform surgery and the best surgical procedure.

METHODS:

Sixty-nine children with meningocele who were admitted to Shanghai Children's Medical Center were analyzed. The relationship between meningocele and other lesions causing tethered cord syndrome was studied by combining magnetic resonance imaging (MRI) and intraoperative findings.

RESULTS:

The MRI results and intraoperative findings showed that 67 children (97%) had associated lesions such as tight filum terminale, fibrous band tethering, spinal cord or cauda equina adhesion, diastematomyelia, arachnoid cyst, and epidermoid cyst. The protruded meninges were repaired, and the intraspinal lesions were treated at the same time. Also, the tethered spinal cord was released. No neurological injuries were observed after surgery.

CONCLUSIONS:

The rate of meningocele associated with tethered cord syndrome is very high. MRI is necessary for the diagnosis of meningocele. Active surgical treatment is recommended immediately after definite diagnosis. During surgery, the surgeon should not only repair the protruded meninges but also explore the spinal canal and release the tethered cord.

• Authors: Song Yun-Hai, Bao Nan, Gao Ping-Ping, Yang Bo, Chen Cheng
• Journal: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery (Childs Nerv Syst) Vol. 31 Issue 11 Pg. 2135-40 (Nov 2015) ISSN: 1433-0350 [Electronic] Germany
• PMID: 26298824 (Publication Type: Journal Article)

Topics

• Cauda Equina (pathology)
• Child
• Child, Preschool
• Female
• Follow-Up Studies
• Humans
• Infant
• Infant, Newborn
• Magnetic Resonance Imaging
• Male
• Medulla Oblongata (pathology)
• Meninges (surgery)
• Meningocele (diagnosis, surgery)
• Neural Tube Defects (pathology, surgery)
• Retrospective Studies