Terminal Myelocystocele: A Rare Variant of Spinal Dysraphism. Case Series and Review of the Literature

Background Data: A terminal myelocystocele occurs at the distal (terminal) end of the spine from the lumbar to coccygeal regions. It is characterized by a skin-covered mass with spinal dysraphism of the associated spinal cord. Within this herniated sac is the distal spinal cord with a large cystic dilatation of its central canal that occupies the posterior aspect and CSF and arachnoid membrane forming a meningocele lying anterior to the terminal cyst of the central canal. Purpose: To report our clinical results with repair and untethering of five cases with terminal myelocystoceles. Study Design: A descriptive cross section retrospective study. Patients and Methods: This is a retrospective analysis of five cases of terminal myelocystoceles treated between February 2008 and March 2015. All patients underwent neurological examination and magnetic resonance imaging (MRI) of the spine. One patient (older one) had presented with weakness of feet dorsiflexion and plantar flexion bilaterally while 4 (80 %) patients had no deficits at all. Bladder bowel involvement was evident in all cases. Results: A total of five patients were included. The mean age of intervention was 5 months. Three of five patients were females. All the patients had lower lumbar and upper sacral mass. The mean operative time of the study group was 150 minutes and the mean operative blood loss was 70CC. The mean hospital stay was 8.4 days. The status of all patients with no preoperative deficits remained unchanged. The patient with motor weakness had improvement during follow up. Conclusion: Surgical correction of terminal myelocystocele is not only for cosmetic reasons but also to untether the spinal cord to prevent future neurological deterioration. During surgical corrections, it is important to perform a thorough intradural inspection to transect all adhesions. (2015ESJ102)

Abstract licence: CC BY-NC-SA

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