| International survey on the management of skin stigmata and suspected tethered cord. | |
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MedLine Citation:
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PMID: 20563728 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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OBJECTIVES: We designed a survey to investigate current international management trends of neonates with lumbar midline skin stigmata suspicious of tethered cord, among pediatric neurosurgeons, focusing on the lower risk stigmata, simple dimples, deviated gluteal folds, and discolorations. Our findings will enable physicians to assess their current diagnosis routine and aid in clarifying management controversies. STUDY DESIGN: A questionnaire on the proposed diagnostic evaluation of seven case reports, each accompanied by relevant imaging, was distributed by e-mail to members of the International Society for Pediatric Neurosurgery, the European Society for Pediatric Neurosurgery, and via the PEDS server list between March and August 2008. RESULTS: Sixty-two questionnaires, completed by experienced professionals with a rather uniform distribution of experience levels, were analyzed. Forty-eight percent do not recommend any imaging of simple dimples, 30% recommend US screening and 22% recommend MR. Seventy-nine percent recommend imaging of deviated gluteal fold with 30% recommending MR. Ninety-two percent recommend imaging infants with hemangiomas with 74% recommending MR. MR for sinus tracts is recommended by 90% if sacral and by 98% if lumber. Eighty-four percent recommend MR for filar cyst. CONCLUSIONS: Our survey demonstrates that management of low-risk skin stigmata, simple dimple, deviated gluteal fold, and discolorations lacks consensus. In addition, a significant sector of the professional community proposes a work-up of simple dimples, sacral tracts, and filar cysts that contradicts established recommendations. A simple classification system is needed to attain a better approach, enabling correct diagnosis of tethered cord without exposing neonates to unnecessary examinations. |
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Authors:
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Penina Ponger; Liat Ben-Sira; Liana Beni-Adani; Paul Steinbok; Shlomi Constantini |
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Publication Detail:
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Type: Journal Article Date: 2010-06-19 |
Journal Detail:
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Title: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery Volume: 26 ISSN: 1433-0350 ISO Abbreviation: Childs Nerv Syst Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8503227 Medline TA: Childs Nerv Syst Country: Germany |
Other Details:
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Languages: eng Pagination: 1719-25 Citation Subset: IM |
Affiliation:
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Department of Pediatric Neurosurgery, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, 6 Weizman St., Tel Aviv, 64239, Israel. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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