Use of the prone position in the MRI evaluation of spinal cord retethering

Details

Serval ID
serval:BIB_E26B5BBB3740
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Use of the prone position in the MRI evaluation of spinal cord retethering
Journal
Pediatric Neurosurgery
Author(s)
Vernet  O., O'Gorman  A. M., Farmer  J. P., McPhillips  M., Montes  J. L.
ISSN
1016-2291 (Print)
Publication state
Published
Issued date
12/1996
Volume
25
Number
6
Pages
286-94
Notes
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Dec
Abstract
In order to determine the impact of magnetic resonance imaging (MRI) in the management of spinal cord retethering, we retrospectively reviewed case and imaging records of 51 patients who underwent MRI examination in supine and prone positions. Group 1 included 8 control patients without cord tethering. They exhibited a normal level of the conus medullaris with normal surrounding subarachnoid space, and consistent anterior migration of the conus within the dural sac on MRI in prone position. Group 2 included 17 patients with tethered cord secondary to occult spinal dysraphism (spinal cord lipoma in 6 patients, thick filum terminale in 4, diastematomyelia in 4, myelomeningocele manque in 2, and dermoid tumour in 1). Supine and prone MRI performed at a median period of time of 6 months after untethering showed resolution of posterior tethering in 5 out of the 7 patients who exhibited pre-operatively dorsal attachment of the spinal cord to the dura. Anterior migration of the conus or of the cord/filum complex in prone position was observed in only 24% of the cases. Group 3 included 26 patients with secondary tethered cord following prior myelomeningocele closure. Their MRI performed at a median interval of time of 11 months following untethering demonstrated resolution of the posterior cord tethering in only 8 out of the 24 patients who exhibited this feature pre-operatively. Anterior migration within the expanded dural sac was never noted in this group. We conclude that spine MRI is of limited value and that prone-positioned MRI is of no additional use in the evaluation of spinal cord retethering.
Keywords
Adolescent Child Female Follow-Up Studies Humans *Magnetic Resonance Imaging Male Postoperative Complications/diagnosis/physiopathology/surgery Prone Position/physiology Recurrence Reoperation Retrospective Studies Spina Bifida Occulta/*diagnosis/physiopathology/surgery Spinal Cord/pathology/physiopathology/surgery Spinal Dysraphism/diagnosis/physiopathology/surgery Supine Position/physiology
Pubmed
Web of science
Create date
25/01/2008 13:13
Last modification date
20/08/2019 16:06
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