Occult spinal dysraphism: How and when do we treat them surgically?

International Conference on Spine and Spinal Disorders

June 30-July 02, 2016 Valencia, Spain

Barbara Spacca

â�?�?Anna Meyerâ�? Childrenâ�?�?s Hospital, Italy

Scientific Tracks Abstracts: J Spine

Abstract :

Among developmental anomaly of the central nervous system, spinal dysraphisms are a complex chapter. On one side, in developed countries, the so called â�?�?openâ�? defects are dramatically decreased in number since the discovery of the protective effect with folic acid supplementation during pregnancy, but on the other hand, such good result did not happen for the so called â�?�?closedâ�? defects. The diagnosis is quite often late during pregnancy and not uncommon after birth or even in adulthood, especially when the skin is not significantly involved. The consequences related to the spine tethering are various and heterogeneous in terms of how they present and how severe they are. Sphincter function, limbs power and sensibility, limbs development, all can be involved. The strategy of surgical treatment follows two possible pathways. One insists on the risk of neurological irreversible deficits, that would severely affect the quality of life and therefore on the opportunity to correct the tethering of the cord as soon as possible to prevent such risk. Another one insists on the possibility that this risk will never happen, and therefore on the opportunity to correct the tethering only if the patient develops a neurological deficit. Besides that, the type of surgery offered can be different, especially for lipomas, with surgeons who deem necessary a complete removal of the fatty component and surgeons who do not. We report our experience on closed spinal dysraphism treated with the aim to reduce the tethering before the irreparable risks happen and with the surgical aim to untether the cord obtaining a good flow of CSF without the complete removal of the fatty component if this aim is obtained. Our database was retrospectively reviewed and 400 cases were analyzed.

Biography :

Barbara Spacca graduated in Medicine and Surgery at the University of Perugia and specialized in Neurosurgery at the University of Florence. She has worked in research and clinical neurosurgery at the Alder Hey Children’s Hospital in Liverpool (UK), the Hospital of Pediatrics “JP Garrahan” Buenos Aires (Argentina) and the Great Ormond Street Hospital, London (UK) and at the Walton Centre for Neurology and Neurosurgery, Liverpool (UK). Since 2010, it is part of the structure of Neurosurgery AOU Meyer.

Email: barbara.spacca@meyer.it