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https://doi.org/10.18502/jsp.v1i2.10492

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authors

  • Abdulrahman Jafar Sabbagh

    Abdulrahman Jafar Sabbagh

    Neurosurgery Division, Department of Surgery, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
  • Rana Moshref

    Rana Moshref

    Neurosurgery Division, Department of Surgery, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
  • Faisal Asiri

    Faisal Asiri

    Neurosurgery Division, Department of Surgery, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
  • Abdulaziz Basurrah

    Abdulaziz Basurrah

    Neurosurgery Division, Department of Surgery, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
  • Abdulrahman Arafah

    Abdulrahman Arafah

    Department of Surgery, Faculty of Medicine of Rabigh, King Abdulaziz University, Saudi Arabia
  • Jamal Kamal

    Jamal Kamal

    Division of Pediatric Surgery, Department of Surgery, College of Medicine, King Abdulaziz University, Saudi Arabia

Published Date

  • Jul 19, 2022

Association between cloacal exstrophy and two limited dorsal myeloschisis lesions: A case report and literature review

Journal of Spine Practice (JSP) / Journal of Spine Practice (JSP): Volume 1, Issue 2 / Pages 75-82

Abstract

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.

Keywords:

Limited dorsal myeloschisis, Tethered cord, Cloacal exstrophy, OEIS complex

References
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