title: Retained medullary cord confirmed by intraoperative neurophysiological mapping.
abstract: BACKGROUND
  A retained medullary cord (RMC) is a rare dysraphic malformation, recently described as a late arrest of secondary neurulation. RMC is also a severely tethering lesion. The critical role of intraoperative neurophysiology to safely manage a RMC has been only anecdotally reported.
  
  
  METHODS
  We describe the case of a RMC in a 1.5-year-old child with Currarino syndrome. At surgery, an apparently normal-looking spinal cord, stretched and tethered by a lipoma to the level of S2-S3, was observed. The border between the functional conus and the non functional RMC was defined through neurophysiological mapping. The cord was sharply interrupted at this level and untethered. A specimen was sent for pathology, which confirmed the presence of glial and neural elements. The post-operative neurological exam was normal.
  
  
  CONCLUSIONS
  Neurosurgical procedure for RMC should only be rendered with intraoperative neurophysiological mapping, as the anatomical judgment would not suffice to allow a safe cutting of these "normal-looking" neural structures.
authors.affiliation: Institute of Neurosurgery, Pediatric Neurosurgery, University Hospital, Piazzale Stefani 1, 37124, Verona, Italy, francesco.sala@univr.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Sala
authors.forename: Giovanni
authors.initials: G
authors.lastname: Barone
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Tramontano
authors.forename: Pasquale
authors.initials: P
authors.lastname: Gallo
authors.forename: Claudio
authors.initials: C
authors.lastname: Ghimenton
mesh_terms: D001003:Anal Canal / Q000002:abnormalities*; D002675:Child, Preschool; D004065:Digestive System Abnormalities / Q000150:complications*; D006801:Humans; D064795:Intraoperative Neurophysiological Monitoring / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods*; D012007:Rectum / Q000002:abnormalities*; D012447:Sacrum / Q000002:abnormalities*; D016135:Spinal Dysraphism / Q000209:etiology / Q000601:surgery*; D013595:Syringomyelia / Q000150:complications*