J Korean Neurosurg Soc.  2020 May;63(3):272-278. 10.3340/jkns.2020.0068.

Spinal Dysraphism in the Last Two Decades : What I Have Seen during the Era of Dynamic Advancement

• Wang KC

• KMID: 2501715
• DOI: http://doi.org/10.3340/jkns.2020.0068

Abstract

Compared to any other decade, the last two decades have been the most dynamic period in terms of advances in the knowledge on spinal dysraphism. Among the several factors of rapid advancement, such as embryology during secondary neurulation and intraoperative neurophysiological monitoring, there is no doubt that Professor Dachling Pang stood high amidst the period. I review here the last two decades from my personal point of view on what has been achieved in the field of spinal dysraphism, focusing on occult tethered cord syndrome, lumbosacral lipomatous malformation, terminal myelocystocele, retained medullary cord, limited dorsal myeloschisis and junctional neural tube defect. There are still many issues to revise, add and extend. Profound knowledge of basic science is critical, as well as refined clinical analysis. I expect that young scholars who follow the footsteps of precedent giants will shed bright light on this topic in the future.

Keyword

Spinal dysraphism; Secondary neurulation; Intraoperative neurophysiological monitoring

Figure

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  Fig. 1. An embryo with histological findings suggestive of lumbosacral lipomatous malformation. B : A magnified view of (A). The embryo shows a back hump, a blending of neuroepithelial and mesenchymal tissues, an indistinct basement membrane of the neuroepithelium and an abnormal shape of the notochord (A : HE, ×100; B : HE, ×200). Modified from Li et al. [14] with permission from Karger Publishers, Basel, Switzerland).

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  Fig. 2. A case of limited dorsal myeloschisis located at the area of secondary neurulation. The spinal cord and adjacent structure below the S1–2 junction are believed to originate from secondary neurulation. The inset shows a typical cigarette-burn skin lesion.

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  Fig. 3. Professor Dachling Pang and his wife, Ms. Lynne Pang, with Korean friends at the 38th Annual Meeting of the International Society for Pediatric Neurosurgery, which was held in Jeju in 2010.

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