Association between cloacal exstrophy and two limited dorsal myeloschisis lesions: A case report and literature review
Background: The term limited dorsal myeloschisis (LDM) was coined by Pang in 1993. It involves incomplete obliteration of the dorsal neural fold in primary neurulation. On the other hand, Cloacal Exstrophy is one of the most complex endodermal anomalies and is usually associated with spinal anomali...
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Knowledge E
2022-07-01
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| Series: | Journal of Spine Practice |
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| Online Access: | https://knepublishing.com/index.php/jsp/article/view/10492 |
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| author | Abdulrahman Jafar Sabbagh Rana Moshref Faisal Asiri Abdulaziz Basurrah Abdulrahman Arafah Jamal Kamal |
| author_facet | Abdulrahman Jafar Sabbagh Rana Moshref Faisal Asiri Abdulaziz Basurrah Abdulrahman Arafah Jamal Kamal |
| author_sort | Abdulrahman Jafar Sabbagh |
| collection | DOAJ |
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Background: The term limited dorsal myeloschisis (LDM) was coined by Pang in 1993. It involves incomplete obliteration of the dorsal neural fold in primary neurulation. On the other hand, Cloacal Exstrophy is one of the most complex endodermal anomalies and is usually associated with spinal anomalies; hence, the term OEIS complex was coined (Omphalocele, Exstrophy of the cloaca, Imperforate anus, and Spinal deformities complex).
Case Description: We report the coexistence of two LDM lesions in tandem (originating at L2 and S2 levels) in a child diagnosed with cloacal exstrophy. Initially, prenatal ultrasound detected the lumbar but not the sacral lesion. The patient was surgically untethered under intraoperative neurophysiologic monitoring (IOM) at four years of age, and this paper reports his one-year follow-up.
Conclusion: Cases of cloacal exstrophy must always be investigated for spinal cord malformations. LDM is rare and requires careful diagnosis. MRI should be done for the whole neuroaxis to rule out associated conditions, including multiplicity. Surgery should be done under IOM to avoid long-term complications.
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| format | Article |
| id | doaj-art-17907de3ffb34c13a4a4c1ddbe81cbcd |
| institution | OA Journals |
| issn | 2789-9454 2789-9462 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | Knowledge E |
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| series | Journal of Spine Practice |
| spelling | doaj-art-17907de3ffb34c13a4a4c1ddbe81cbcd2025-08-20T02:04:53ZengKnowledge EJournal of Spine Practice2789-94542789-94622022-07-011210.18502/jsp.v1i2.10492Association between cloacal exstrophy and two limited dorsal myeloschisis lesions: A case report and literature reviewAbdulrahman Jafar Sabbagh0Rana Moshref1Faisal Asiri2Abdulaziz Basurrah3Abdulrahman Arafah4Jamal Kamal5Neurosurgery Division, Department of Surgery, College of Medicine, King Abdulaziz University, Jeddah, Saudi ArabiaNeurosurgery Division, Department of Surgery, College of Medicine, King Abdulaziz University, Jeddah, Saudi ArabiaNeurosurgery Division, Department of Surgery, College of Medicine, King Abdulaziz University, Jeddah, Saudi ArabiaNeurosurgery Division, Department of Surgery, College of Medicine, King Abdulaziz University, Jeddah, Saudi ArabiaDepartment of Surgery, Faculty of Medicine of Rabigh, King Abdulaziz University, Saudi ArabiaDivision of Pediatric Surgery, Department of Surgery, College of Medicine, King Abdulaziz University, Saudi Arabia Background: The term limited dorsal myeloschisis (LDM) was coined by Pang in 1993. It involves incomplete obliteration of the dorsal neural fold in primary neurulation. On the other hand, Cloacal Exstrophy is one of the most complex endodermal anomalies and is usually associated with spinal anomalies; hence, the term OEIS complex was coined (Omphalocele, Exstrophy of the cloaca, Imperforate anus, and Spinal deformities complex). Case Description: We report the coexistence of two LDM lesions in tandem (originating at L2 and S2 levels) in a child diagnosed with cloacal exstrophy. Initially, prenatal ultrasound detected the lumbar but not the sacral lesion. The patient was surgically untethered under intraoperative neurophysiologic monitoring (IOM) at four years of age, and this paper reports his one-year follow-up. Conclusion: Cases of cloacal exstrophy must always be investigated for spinal cord malformations. LDM is rare and requires careful diagnosis. MRI should be done for the whole neuroaxis to rule out associated conditions, including multiplicity. Surgery should be done under IOM to avoid long-term complications. https://knepublishing.com/index.php/jsp/article/view/10492Limited dorsal myeloschisisTethered cordCloacal exstrophyOEIS complex |
| spellingShingle | Abdulrahman Jafar Sabbagh Rana Moshref Faisal Asiri Abdulaziz Basurrah Abdulrahman Arafah Jamal Kamal Association between cloacal exstrophy and two limited dorsal myeloschisis lesions: A case report and literature review Journal of Spine Practice Limited dorsal myeloschisis Tethered cord Cloacal exstrophy OEIS complex |
| title | Association between cloacal exstrophy and two limited dorsal myeloschisis lesions: A case report and literature review |
| title_full | Association between cloacal exstrophy and two limited dorsal myeloschisis lesions: A case report and literature review |
| title_fullStr | Association between cloacal exstrophy and two limited dorsal myeloschisis lesions: A case report and literature review |
| title_full_unstemmed | Association between cloacal exstrophy and two limited dorsal myeloschisis lesions: A case report and literature review |
| title_short | Association between cloacal exstrophy and two limited dorsal myeloschisis lesions: A case report and literature review |
| title_sort | association between cloacal exstrophy and two limited dorsal myeloschisis lesions a case report and literature review |
| topic | Limited dorsal myeloschisis Tethered cord Cloacal exstrophy OEIS complex |
| url | https://knepublishing.com/index.php/jsp/article/view/10492 |
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