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Dorsal midline cutaneous stigmata associated with occult spinal dysraphism in pediatric patients
PURPOSE: To investigate the prevalence of occult spinal dysraphism (OSD) and subsequent neurosurgery in pediatric patients with isolated or combined dorsal midline cutaneous stigmata with or without other congenital malformations. METHODS: We carried out a retrospective review of patients who underw...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Pediatric Society
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6382965/ https://www.ncbi.nlm.nih.gov/pubmed/30304899 http://dx.doi.org/10.3345/kjp.2018.06744 |
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author | Sung, Hyun Jung Lee, Hyun-Seung |
author_facet | Sung, Hyun Jung Lee, Hyun-Seung |
author_sort | Sung, Hyun Jung |
collection | PubMed |
description | PURPOSE: To investigate the prevalence of occult spinal dysraphism (OSD) and subsequent neurosurgery in pediatric patients with isolated or combined dorsal midline cutaneous stigmata with or without other congenital malformations. METHODS: We carried out a retrospective review of patients who underwent sonography or magnetic resonance imaging (MRI) for OSD because of suspicion of dorsal midline cutaneous stigmata (presumed to be a marker for OSD) between January 2012 and June 2017. Information about patient characteristics, physical examination findings, spinal ultrasound and MRI results, neurosurgical notes, and accompanying congenital anomalies was collected. RESULTS: Totally 250 patients (249 ultrasound and one MRI screening) were enrolled for analysis. Eleven patients underwent secondary MRI examinations. The prevalence of OSD confirmed by an MRI was 2.4% (6 patients including one MRI screening). Five patients (2%) had tethered cord and underwent prophylactic neurosurgery, 3 of whom had a sacrococcygeal dimple and a fibrofatty mass. Prevalence of tethered cord increased as markers associated with a sacrococcygeal dimple increased (0.5% of the isolated marker group, 8.1% of the 2-marker group, and 50% of the 3-marker group). Incidence of OSD with surgical detethering in 17 other congenital anomaly patients was 11.8%, which was higher than the 1.3% in 233 patients without other congenital anomalies. CONCLUSION: Our results suggest that the presence of dorsal midline cutaneous stigmata, particularly fibrofatty masses, along with a sacrococcygeal dimple is associated with OSD or cord tethering requiring surgery. OSD should be suspected in patients with concurrent occurrence of other congenital anomalies. |
format | Online Article Text |
id | pubmed-6382965 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Korean Pediatric Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-63829652019-03-01 Dorsal midline cutaneous stigmata associated with occult spinal dysraphism in pediatric patients Sung, Hyun Jung Lee, Hyun-Seung Korean J Pediatr Original Article PURPOSE: To investigate the prevalence of occult spinal dysraphism (OSD) and subsequent neurosurgery in pediatric patients with isolated or combined dorsal midline cutaneous stigmata with or without other congenital malformations. METHODS: We carried out a retrospective review of patients who underwent sonography or magnetic resonance imaging (MRI) for OSD because of suspicion of dorsal midline cutaneous stigmata (presumed to be a marker for OSD) between January 2012 and June 2017. Information about patient characteristics, physical examination findings, spinal ultrasound and MRI results, neurosurgical notes, and accompanying congenital anomalies was collected. RESULTS: Totally 250 patients (249 ultrasound and one MRI screening) were enrolled for analysis. Eleven patients underwent secondary MRI examinations. The prevalence of OSD confirmed by an MRI was 2.4% (6 patients including one MRI screening). Five patients (2%) had tethered cord and underwent prophylactic neurosurgery, 3 of whom had a sacrococcygeal dimple and a fibrofatty mass. Prevalence of tethered cord increased as markers associated with a sacrococcygeal dimple increased (0.5% of the isolated marker group, 8.1% of the 2-marker group, and 50% of the 3-marker group). Incidence of OSD with surgical detethering in 17 other congenital anomaly patients was 11.8%, which was higher than the 1.3% in 233 patients without other congenital anomalies. CONCLUSION: Our results suggest that the presence of dorsal midline cutaneous stigmata, particularly fibrofatty masses, along with a sacrococcygeal dimple is associated with OSD or cord tethering requiring surgery. OSD should be suspected in patients with concurrent occurrence of other congenital anomalies. Korean Pediatric Society 2019-02 2018-10-01 /pmc/articles/PMC6382965/ /pubmed/30304899 http://dx.doi.org/10.3345/kjp.2018.06744 Text en Copyright © 2019 by The Korean Pediatric Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Sung, Hyun Jung Lee, Hyun-Seung Dorsal midline cutaneous stigmata associated with occult spinal dysraphism in pediatric patients |
title | Dorsal midline cutaneous stigmata associated with occult spinal dysraphism in pediatric patients |
title_full | Dorsal midline cutaneous stigmata associated with occult spinal dysraphism in pediatric patients |
title_fullStr | Dorsal midline cutaneous stigmata associated with occult spinal dysraphism in pediatric patients |
title_full_unstemmed | Dorsal midline cutaneous stigmata associated with occult spinal dysraphism in pediatric patients |
title_short | Dorsal midline cutaneous stigmata associated with occult spinal dysraphism in pediatric patients |
title_sort | dorsal midline cutaneous stigmata associated with occult spinal dysraphism in pediatric patients |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6382965/ https://www.ncbi.nlm.nih.gov/pubmed/30304899 http://dx.doi.org/10.3345/kjp.2018.06744 |
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