Child's Nervous System

, Volume 34, Issue 12, pp 2497–2501 | Cite as

Limited dorsal myeloschisis with no extradural stalk linking to a flat skin lesion: a case report

  • Akiko Hiraoka
  • Takato Morioka
  • Nobuya Murakami
  • Satoshi O. Suzuki
  • Masahiro Mizoguchi
Case Report



Limited dorsal myeloschisis (LDM) is characterized by a fibroneural stalk linking the skin lesion to the underlying spinal cord.

Case presentation 

A 7-month-old girl with a lumbosacral “cigarette-burn” flat skin lesion underwent untethering surgery. The intradural tethering stalk appeared to originate at the dural wall and join the cord with no extradural stalk linking to the skin lesion. Histological examination of the intradural stalk revealed glial fibrillary acidic protein-immunopositive neuroglial tissues in the fibrocollagenous band, which is the central histopathological feature of an LDM stalk.


It is conceivable that the LDM stalk in our patient was originally linked to the skin lesion and subsequently regressed and was replaced by mature adipose tissue. We should be mindful of possible variations in the morphological features of LDM.


Glial fibrillary acidic protein Fibroneural stalk Untethering 



We thank Jane Charbonneau, DVM, from Edanz Group ( for editing a draft of this manuscript.

Funding information

This work was partly supported by the Research Foundation of Fukuoka Children’s Hospital.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Lee JY, Chong S, Choi YH, Phi JH, Cheon J-E, Kim S-K, Park SH, Kim I-O, Wang K-C (2017) Modification of surgical procedure for “probable” limited dorsal myeloschisis. J Neurosurg Pediatr 19:616–619CrossRefGoogle Scholar
  2. 2.
    Lee JY, Park S-H, Chong S, Phi JH, Kim S-K, Cho B-K, Wang K-C (2018) Congenital dermal sinus and limited dorsal myeloschisis: “Spectrum disorders” of incomplete dysjunction between cutaneous and neural ectoderms. Neurosurgery (Epub ahead of print)Google Scholar
  3. 3.
    Morioka T, Suzuki SO, Murakami N, Shimogawa T, Mukae N, Inoha S, Sasaguri T, Iihara K (2018) Neurosurgical pathology of limited dorsal myeloschisis. Childs Nerv Syst 34:293–303CrossRefGoogle Scholar
  4. 4.
    Morioka T, Suzuki SO, Murakami N, Mukae N, Shimogawa T, Haruyama H, Kira R, Iihara K (2018) Surgical histopathology of limited dorsal myeloschisis with flat skin lesion. Childs Nerv Syst (Epub ahead of print)Google Scholar
  5. 5.
    Morota N, Ihara S, Ogiwara H (2017) New classification of spinal lipomas based on embryonic stage. J Neurosurg Pediatr 19:428–439CrossRefGoogle Scholar
  6. 6.
    Murakami N, Morioka T, Hashiguchi K, Yoshiura T, Hiwatashi K, Suzuki SO, Nakamizo A, Amano T, Hata N, Sasaki T (2013) Usefulness of three-dimensional T1-weighted spoiled gradient-recalled echo and three-dimensional heavily T2-weighted images in preoperative evaluation of spinal dysraphism. Childs Nerv Syst 29:1905–1914CrossRefGoogle Scholar
  7. 7.
    Pang D, Zovickian J, Oviedo A, Moes GS (2010) Limited dorsal myeloschisis: a distinctive clinicopathological entity. Neurosurgery 67:1555–1580CrossRefGoogle Scholar
  8. 8.
    Pang D, Zovickian J, Wong S-T, Hou YJ, Moes GS (2013) Limited dorsal myeloschisis: a not-so-rare form of primary neurulation defect. Childs Nerv Syst 29:1459–1484CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Pediatric NeurologyFukuoka Children’s HospitalFukuokaJapan
  2. 2.Department of NeurosurgeryFukuoka Children’s HospitalFukuokaJapan
  3. 3.Department of Neuropathology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  4. 4.Department of NeurosurgeryKitakyushu Municipal Medical CenterKitakyushuJapan

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