Surgical treatment of the lipomeningocele in children (a review)
Referat
Lipomeningocele is a variant of a latent form of spinal dysraphism, in which during embryogenesis there is no complete separation between the neuroectoderm and mesenchymal elements that form the spine and soft tissues around the neural tube. The frequency of occurrence is 1:4000 newborns, which is 60% of all spinal cord lipomas. Depending on the anatomical relationship of lipomas with the spinal cord, the following forms are distinguished: dorsal lipoma, caudal lipoma, transitional lipoma. In relation to the dura mater and the spinal canal, they are divided into intradural, intra, and extradural. Treatment strategies vary depending on the subtype, neurological deficit, and surgical techniques.
This article is a review of the literature on the evaluation and results of surgical treatment of lipomerengocele in children.
Mualliflar haqida
Adabiyotlar ro'yxati
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functional grade (a grading system incorporating neurolog-ical, urological, and orthopedic deficits) in 10% of patients and deterioration in 5.8%, with the remainder maintaining the same functional grade. Those patients whose conditions deteriorated the most commonly displayed worsening bowel and bladder function [55]. A series of 43 patients demonstrat¬ed that 84% of patients maintained stable urodynamic and neurological function after surgery and noted the primary predictor of normal bladder function in the long term was normal preoperative urodynamic status [78].
Conclusions
Lipomeningocele is a form of closed neural tube defect with unclear predisposing factors. Due to the risk of worsening neurological and urological function secondary to a tethered spinal cord, it continues to be important to identify this condition for timely intervention. Magnetic resonance im-aging and neurophysiological testing are useful tools for iden¬tifying the spinal cord pathology and assisting with surgical planning. Because bowel and bladder paresis remains the pri¬mary morbidity of this disease, early intervention either prior to symptom development, or at the first onset of symptoms, is recommended to optimize postoperative outcome.
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