Pre- and post-operative hydromyelia in spinal dysraphism.
OBJECTIVE
There has been limited description of hydromyelia after surgery for spinal dysraphism. The opportunity to compare pre- and post-operative hydromyelia in patients with spinal dysraphism has been possible in two groups of patients using MRI. Post-operative assessment and possible relationship of hydromyelia to clinical findings has been made during a 7- to 14-year period.


METHODS
A total of 38 patients with congenital lumbar or sacral lipomas and 20 with diastematomyelia were studied pre-operatively with a 1.5-T MRI. Most patients in each group were examined with surveillance MRI (1.5 T) post-operatively. Clinical correlations were carried out with each examination.


RESULTS
Of the 38 dorsal or terminal lipoma post-operative patients, hydromyelia increased in 3 and was a new finding in 4. One symptomatic patient in the latter group had extensive septated lumbar hydromyelia. In 8 of 20 diastematomyelia patients, pre-operative hydromyelia was unchanged post-operatively. Hemicord hydromyelia developed in 1.


CONCLUSIONS
Hydromyelia of varying degree was found in almost one-third of post-operative dorsal or terminal lipoma patients and nearly one-half of diastematomyelia patients. In five post-operative lipoma and two diastematomyelia patients, significant neurological findings remained. One of the six post-operative lipomas had new extensive lumbar hydromyelia that may have been responsible for the patient's symptoms. In the remaining symptomatic patients, hydromyelia was absent or modest.
Scatliff
James H
JH
Department of Radiology, School of Medicine, University of North Carolina, 511 Old Infirmary Building, Chapel Hill, NC 27599, USA. jtelle@med.unc.edu
Hayward
Richard
R
Armao
Diane
D
Kwon
Lanna
L
D002648:Child; D005260:Female; D006801:Humans; D007223:Infant; D008067:Lipoma / Q000151:congenital / Q000175:diagnosis / Q000601:surgery*; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging; D008297:Male; D013120:Spinal Cord Neoplasms / Q000151:congenital / Q000175:diagnosis / Q000601:surgery*; D016135:Spinal Dysraphism / Q000175:diagnosis / Q000601:surgery*; D013595:Syringomyelia / Q000175:diagnosis / Q000601:surgery*