Foreign Body Reactions Causing Spinal Cord Tethering: a Case-based Update

Overview

Journal Childs Nerv Syst

Specialty Pediatrics

Date 2010 Mar 12

PMID 20221610

Citations 5

Authors

Juan F Martinez-Lage

Belen Ferri Niguez

Maria Jose Almagro

Maria Cristina Rodriguez

Miguel A Perez-Espejo

Affiliations

Soon will be listed here.

Abstract

Background: Patients operated on for myelomeningocele (MMC) and lipomeningocele (LMC) can suffer from late functional worsening that, in many cases, is due to spinal cord tethering by the post-repair scarring process.

Illustrative Cases: In this case-based update, we report two patients operated on for MMC and LMC, respectively, who presented the clinical manifestations of spinal cord tethering, which we attributed to severe foreign body reactions to the materials used at their primary back surgery. In the first case, the cause of the tethering was an intense fibrotic scar around the silk suture used at the initial MMC repair, while in the second one, it was due to a fibrotic mesh containing the lyophilized dural graft implanted for LMC surgery. After a search of the current literature, we were unable to find cases of spinal cord tethering related to excessive scarring after dural repair with foreign materials used for the surgical correction of spinal dysraphism.

Discussion And Conclusions: The pathogenesis of spinal cord tethering in our instances closely relate with the histopathologically observed intense foreign body reaction around the materials used at the primary back surgery. We recommend avoiding as much as possible the use of foreign materials during the initial repair of spinal dysraphism.

Citing Articles

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Percutaneous fetoscopic spina bifida repair: effect on ambulation and need for postnatal cerebrospinal fluid diversion and bladder catheterization.

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Limited dorsal myeloschisis in three cats: a distinctive form of neural tube defect.

Butterfield S, Garcia-Gonzalez B, Driver C, Rusbridge C JFMS Open Rep. 2020; 6(1):2055116920924307.

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Intense FDG Uptake around the Inguinal Surgical Mesh 5 Years after Operation: Case Report and Review of the Literature.

Bahceci T, Nursal G, Aydin M Mol Imaging Radionucl Ther. 2013; 21(1):35-7.

PMID: 23486372 PMC: 3590964. DOI: 10.4274/Mirt.021917.

Comment on: The value of post-operative MR in tethered cord: a review of 140 cases by P. David Halevi, Suhas Udayakumaran, Liat Ben-Sira, Shlomi Constantini.

Martinez-Lage J Childs Nerv Syst. 2011; 27(12):2165-6.

PMID: 21956778 DOI: 10.1007/s00381-011-1579-6.

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