Skip to main content

Advertisement

SpringerLink
Log in

A practical clinical classification of spinal neural tube defects

  • Presidential Address
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Current commonly used terminology to describe neural tube defects (NTD) is inconsistent, overlapping, contradictory and, at times, inaccurate making it difficult to convey the nature of the malformation and what needs to be done to optimally treat patients with these congenital abnormalities.

NTD can be broadly divided into those that are open with exposed neural tissue and leaking cerebrospinal fluid (CSF) and those that are closed with no exposed neural tissue nor loss of CSF. It appears that the loss of CSF during development is the underlying factor that leads to the entire central nervous system involvement with an open NTD and lack thereof with a closed NTD, wherein only the spinal cord is malformed. There are, however, rare transitional cases that bridge the gap between the two forms.

Agreeing on a nomenclature that is used in a standard fashion would be of help in addressing this group of congenital anomalies that have a great deal of variability and, at times, can be quite complex.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13
Fig. 14
Fig. 15
Fig. 16
Fig. 17
Fig. 18
Fig. 19
Fig. 20
Fig. 21
Fig. 22
Fig. 23
Fig. 24
Fig. 25
Fig. 26
Fig. 27
Fig. 28
Fig. 29
Fig. 30
Fig. 31
Fig. 32
Fig. 33
Fig. 34
Fig. 35
Fig. 36
Fig. 37

Similar content being viewed by others

References

  1. Stedman TL (2006) Stedman’s medical dictionary, 28th edn. Lippincott Williams & Wilkins, Baltimore, p 1638 (Raphe)

    Google Scholar 

  2. Stedman TL (2006) Stedman’s medical dictionary, 28th edn. Lippincott Williams & Wilkins, Baltimore, p 601 (Dysraphism)

    Google Scholar 

  3. Stedman TL (2006) Stedman’s medical dictionary, 28th edn. Lippincott Williams & Wilkins, Baltimore, p 1805 (Spina bifida)

    Google Scholar 

  4. McLone DG, Knepper PA (1989) The cause of Chiari II malformation: a unified theory. Pediatr Neurosci 15:1–12

  5. Adzick NS, Thom EA, Spong CY, Brock III JW , Burrows PK, Johnson MP, Howell LJ, Farrell JA, Dabrowiak ME, Sutton LN., Gupta N, Tulipan NB, D’Alton ME, Farmer DL (2011) A randomized trial of prenatal versus postnatal repair of myelomeningocele. N Engl J Med 364:993–1004

  6. Welch K, Shillito J, Strand R., Fischer EG, Winston KR (1981) Chiari I “malformation”—an acquired disorder? J Neurosurg 55:604–609

  7. Nakatsu T, Uwabe C, Shiota K (2000) Neural tube closure in humans initiates at multiple sites: evidence from human embryos and implications for the pathogenesis of neural tube defects. Anat Embryol 201:455–466

    Article  CAS  PubMed  Google Scholar 

  8. Pang D, Zovickian J, Wong ST, Hou YJ, Moes G (2013) Limited dorsal myeloschisis: a not-so-rare form of primary neurulation defect. Childs Nerv Syst 29:1459–1484

  9. Steinbok P, Cochrane DD (1995) Cervical meningoceles and myelocystoceles: a unifying hypothesis. Pediatr Neurosurg 23:317–322

    Article  CAS  PubMed  Google Scholar 

  10. Dias MS, Azizkhan RG (1998) A novel embryogenetic mechanism for Currarino’s triad: inadequate dorsoventral separation of the caudal eminence from hindgut endoderm. Pediatr Neurosurg 28:223–229

    Article  CAS  PubMed  Google Scholar 

  11. Stedman TL (2006) Stedman’s medical dictionary, 28th edn. Lippincott Williams & Wilkins, Baltimore, p 1268 (Myelocele)

    Google Scholar 

  12. Stedman TL (2006) Stedman’s medical dictionary, 28th edn. Lippincott Williams & Wilkins, Baltimore, p 1268 (Myelocyst)

    Google Scholar 

  13. Stedman TL (2006) Stedman’s medical dictionary, 28th edn. Lippincott Williams & Wilkins, Baltimore, p 1269 (Myelocystocele)

    Google Scholar 

  14. Di Rocco C (2013) Comment to the paper by L. May et al: Lack of uniformity in the clinical assessment of children with lipomyelomeningocele. A review of the literature and recommendations for the future. Childs Nerv Syst 29:971

    Article  PubMed  Google Scholar 

  15. May L, Hayward R, Chakraborty A, Franck L, Manzotti G, Wray J, Thompson D (2013) Lack of uniformity in the clinical assessment of children with lipomyelomeningocele: a review of the literature and recommendations for the future. Childs Nerv Syst 29:961–970

  16. Pang D, Dias MS, Ahab-Barmada M (1992) Split cord malformations, part I: a unified theory of embryogenesis for double spinal cord malformations. Neurosurgery 3:451–480

    Article  Google Scholar 

  17. Jeelani Y, Mosich GM, McComb JG (2013) Closed neural tube defects in children with caudal regression. Childs Nerv Syst 29:1451–1457

    Article  PubMed  Google Scholar 

  18. Brian LR, Sibbald B, Sarnat HB (2013) Comment to the paper: Multiple neural tube defects may not be very rare by SK Mahalik et al. Childs Nerv Syst 29:881–882

    Article  Google Scholar 

  19. Mahalik SK, Vaze D, Kanojia RP, Narasimhan KL, Rao KLN (2013) Multiple neural tube defects may not be very rare. Childs Nerv Syst 29:609–619

  20. Mahalik SK, Vaze D, Kanojia RP, Narasimhan KL, Rao KLN (2013) Authors’ reply to comments on “Multiple neural tube defects may not be very rare” by SK Mahalik et al. Childs Nerv Syst 29:883–884

  21. McComb JG (1985) Congenital dermal sinus. In: Wilkins RH, Rengachary SS (eds) Neurosurgery. McGraw-Hill, New York, p 2082

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Neurosurgery, Children’s Hospital Los Angeles, 1300 N. Vermont Avenue, Suite 1006, Los Angeles, CA, 90027, USA

    J. Gordon McComb

  2. Department of Neurological Surgery, Keck School of Medicine, University of Southern California, 1300 N. Vermont Avenue, Suite 1006, Los Angeles, CA, 90027, USA

    J. Gordon McComb

Authors
  1. J. Gordon McComb
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Gordon McComb.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

McComb, J.G. A practical clinical classification of spinal neural tube defects. Childs Nerv Syst 31, 1641–1657 (2015). https://doi.org/10.1007/s00381-015-2845-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-015-2845-9

Keywords

Search

Navigation