Original Paper

Child's Nervous System

, Volume 19, Issue 2, pp 106-108

Progression of terminal syrinx in occult spina bifida after untethering

  •  B. SadeAffiliated withDepartment of Pediatric Neurosurgery, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, 6, Weizman Street, Tel Aviv 64239, Israel
  • ,  L. Beni-AdaniAffiliated withDepartment of Pediatric Neurosurgery, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, 6, Weizman Street, Tel Aviv 64239, Israel
  • ,  L. Ben-SiraAffiliated withUnit of Pediatric Imaging, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, 6, Weizman Street, Tel Aviv 64239, Israel
  • ,  S. ConstantiniAffiliated withDepartment of Pediatric Neurosurgery, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, 6, Weizman Street, Tel Aviv 64239, Israel

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Abstract

Object. The association of spinal dysraphism and terminal syringomyelia is a well-known entity, and untethering with or without syrinx drainage is usually the surgery of choice. However, progression of the previously existing syrinx after an untethering procedure is an uncommon course. The objective of this study was to discuss the diagnostic, surgical, and follow-up consequences of such an occurrence.

Methods. Four children with occult spina bifida associated with terminal syrinx at the time of initial presentation are included in this study. After the primary releasing procedure, all developed enlargement of the syrinx. Two of them were operated on for placement of a syringo-subarachnoid shunt, while the other two were followed up conservatively. One of the shunted patients also had a second releasing procedure.

Conclusion. Progression of the pre-existing terminal syrinx after the primary untethering procedure should be kept in mind even in the absence of overt neurological progression.

Syringomyelia Lipomyelomeningocele Syringo-subarachnoid shunt Tethered cord Spina bifida