Retained medullary cord in humans: late arrest of secondary neurulation

Neurosurgery
Dachling PangGreg Moes

Abstract

Formation of the caudal spinal cord in vertebrates is by secondary neurulation, which begins with mesenchyme-epithelium transformation within a pluripotential blastema called the tail bud or caudal cell mass, from thence initiating an event sequence proceeding from the condensation of mesenchyme into a solid medullary cord, intrachordal lumen formation, to eventual partial degeneration of the cavitatory medullary cord until, in human and tailless mammals, only the conus and filum remain. We describe a secondary neurulation malformation probably representing an undegenerated medullary cord that causes tethered cord symptoms. We present 7 patients with a robust elongated neural structure continuous from the conus and extending to the dural cul-de-sac, complete with issuing nerve roots, which, except in 2 infants, produced neurological deficits by tethering. Intraoperative motor root and direct cord stimulation indicated that a large portion of this stout neural structure was "redundant" nonfunctional spinal cord below the true conus. Histopathology of the redundant cord resected at surgery showed a glioneuronal core with ependyma-lined lumen, nerve roots, and dorsal root ganglia, corroborating the picture of a blighted spinal cor...Continue Reading

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Citations

Sep 10, 2013·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Laura Grazia ValentiniMarika Furlanetto
Sep 10, 2013·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Dachling PangGreg Moes
Sep 10, 2013·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Francesco SalaCarlo Mazza
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Related Concepts

Surface Electromyography
Iniencephaly
Spinal Cord
Neurulation
Cell Death
Abnormal Degeneration
Ganglia, Spinal
Nerve Degeneration
Spinal Cord
Vertebrates

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