{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T02:43:05Z","timestamp":1781664185677,"version":"3.54.5"},"reference-count":8,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,5]]},"abstract":"OBJECTIVE<\/jats:title>Since the entity limited dorsal myeloschisis (LDM) was proposed, numerous confusing clinical cases have been renamed according to the embryopathogenesis. However, clinical application of this label appears to require some clarification with regard to pathology. There have been cases in which all criteria for the diagnosis of LDM were met except for the presence of a neural component in the stalk, an entity the authors call \u201cprobable\u201d LDM. The present study was performed to meticulously review these cases and suggest that a modified surgical strategy using limited laminectomy is sufficient to achieve the surgical goal of untethering.<\/jats:p><\/jats:sec>METHODS<\/jats:title>The authors retrospectively reviewed the imaging findings, operative notes, and pathology reports of spinal dysraphism patients with subcutaneous stalk lesions who had presented to their institution between 2010 and 2014.<\/jats:p><\/jats:sec>RESULTS<\/jats:title>Among 33 patients with LDM, 13 had the typical nonsaccular lesions with simple subcutaneous stalks connecting the skin opening to the spinal cord. Four cases had \u201ctrue\u201d LDM meeting all criteria for diagnosis, including pathological confirmation of CNS tissue by immunohistochemical staining with glial fibrillary acidic protein. There were also 9 cases in which all clinical, imaging, and surgical findings were compatible with LDM, but the \u201cneural\u201d component in the resected stalk was not confirmed. For all the cases, limited exposure of the stalk was done and satisfactory untethering was achieved.<\/jats:p><\/jats:sec>CONCLUSIONS<\/jats:title>One can speculate based on the initial error of embryogenesis that if the entire stalk were traced to the point of insertion on the cord, the neural component would be proven. However, this would require an extended level of laminectomy\/laminotomy, which may be unnecessary, at least with regard to the completeness of untethering. Therefore, the authors propose that for some selected cases of LDM, a minimal extent of laminectomy may suffice for untethering, although it may be insufficient for diagnosing a true LDM.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2016.12.peds16171","type":"journal-article","created":{"date-parts":[[2017,2,17]],"date-time":"2017-02-17T14:57:22Z","timestamp":1487343442000},"page":"616-619","source":"Crossref","is-referenced-by-count":29,"title":["Modification of surgical procedure for \u201cprobable\u201d limited dorsal myeloschisis"],"prefix":"10.3171","volume":"19","author":[{"given":"Ji Yeoun","family":"Lee","sequence":"first","affiliation":[{"name":"Divisions of Pediatric Neurosurgery and"},{"name":"Department of Anatomy, Seoul National University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangjoon","family":"Chong","sequence":"additional","affiliation":[{"name":"Divisions of Pediatric Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Hun","family":"Choi","sequence":"additional","affiliation":[{"name":"Pediatric Radiology, Seoul National University Children's Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Hoon","family":"Phi","sequence":"additional","affiliation":[{"name":"Divisions of Pediatric Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung-Eun","family":"Cheon","sequence":"additional","affiliation":[{"name":"Pediatric Radiology, Seoul National University Children's Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung-Ki","family":"Kim","sequence":"additional","affiliation":[{"name":"Divisions of Pediatric Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Hye","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Pathology, Seoul National University Hospital; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In-One","family":"Kim","sequence":"additional","affiliation":[{"name":"Pediatric Radiology, Seoul National University Children's Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyu-Chang","family":"Wang","sequence":"additional","affiliation":[{"name":"Divisions of Pediatric Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-peds16171","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1168","DOI":"10.1227\/01.NEU.0000215955.18762.32","article-title":"Cervical myelomeningocele","volume":"58","author":"Habibi Z","year":"2006","unstructured":"Habibi Z, Nejat F, Tajik P, Kazmi SS, Kajbafzadeh AM: Cervical myelomeningocele. 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