title: Is repair of the protruded meninges sufficient for treatment of meningocele?
abstract: OBJECTIVE
  The present study aimed to investigate the relationship between meningocele and tethered cord syndrome, diagnosis of meningocele associated with tethered cord syndrome, and when to perform surgery and the best surgical procedure.
  
  
  METHODS
  Sixty-nine children with meningocele who were admitted to Shanghai Children's Medical Center were analyzed. The relationship between meningocele and other lesions causing tethered cord syndrome was studied by combining magnetic resonance imaging (MRI) and intraoperative findings.
  
  
  RESULTS
  The MRI results and intraoperative findings showed that 67 children (97%) had associated lesions such as tight filum terminale, fibrous band tethering, spinal cord or cauda equina adhesion, diastematomyelia, arachnoid cyst, and epidermoid cyst. The protruded meninges were repaired, and the intraspinal lesions were treated at the same time. Also, the tethered spinal cord was released. No neurological injuries were observed after surgery.
  
  
  CONCLUSIONS
  The rate of meningocele associated with tethered cord syndrome is very high. MRI is necessary for the diagnosis of meningocele. Active surgical treatment is recommended immediately after definite diagnosis. During surgery, the surgeon should not only repair the protruded meninges but also explore the spinal canal and release the tethered cord.
authors: Neurosurgery Department, Shanghai Children's Medical Center Affiliated to the Medical School of Shanghai Jiaotong University, Shanghai, 200127, China.
authors: Song
authors: S
authors: Yun-Hai
authors: Neurosurgery Department, Shanghai Children's Medical Center Affiliated to the Medical School of Shanghai Jiaotong University, Shanghai, 200127, China. bnscmc@shsmu.edu.cn.
authors: Bao
authors: B
authors: Nan
authors: Neurosurgery Department, Shanghai Children's Medical Center Affiliated to the Medical School of Shanghai Jiaotong University, Shanghai, 200127, China.
authors: Gao
authors: G
authors: Ping-Ping
authors: Neurosurgery Department, Shanghai Children's Medical Center Affiliated to the Medical School of Shanghai Jiaotong University, Shanghai, 200127, China.
authors: Yang
authors: Y
authors: Bo
authors: Neurosurgery Department, Shanghai Children's Medical Center Affiliated to the Medical School of Shanghai Jiaotong University, Shanghai, 200127, China.
authors: Chen
authors: C
authors: Cheng
mesh_terms: D002420:Cauda Equina / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D008526:Medulla Oblongata / Q000473:pathology; D008578:Meninges / Q000601:surgery*; D008588:Meningocele / Q000175:diagnosis / Q000601:surgery*; D009436:Neural Tube Defects / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies
keywords: Diagnosis; Meningocele; Surgery; Tethered cord syndrome