{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T23:00:35Z","timestamp":1775084435454,"version":"3.50.1"},"reference-count":20,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1991,5]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 In a series of 75 patients with surgically treated lipomyelomeningoceles, the neurological condition of six patients deteriorated 6 months to 14 years after the operation due to repeat tethering of the spinal cord. The tethering resulted from postoperative dense adhesion between the cord and the overlying dura mater. Two of the six patients underwent conventional repeat untethering procedures, and the remaining four were successfully treated with a new surgical technique developed by the authors to prevent such dural adhesion. For this procedure, after complete untethering of the spinal cord, the lumbosacral cord is retained in the center of the dural sac by fine stay sutures between the pia mater of the conus medullaris and the ventral dura mater. In addition, the dura mater is tacked to the posterior arch which is reconstructed with bone grafts at one or two bifid vertebral levels. During a postoperative follow-up period of 1 to 3 years, no further deterioration has been observed and magnetic resonance studies have demonstrated a space filled with cerebrospinal fluid (CSF) around the lumbosacral cord. The authors conclude that long-term observation, both neurological and radiological, is essential even after successful repair of a lipomyelomeningocele. This new surgical procedure can maintain a CSF bath around the lumbosacral cord, thus preventing dural adhesion. Application of this technique will hopefully be beneficial in lipomyelomeningocele patients with a high risk of cord retethering after initial repair.<\/jats:p>","DOI":"10.3171\/jns.1991.74.5.0709","type":"journal-article","created":{"date-parts":[[2009,5,19]],"date-time":"2009-05-19T16:19:47Z","timestamp":1242749987000},"page":"709-714","source":"Crossref","is-referenced-by-count":49,"title":["Surgical treatment of the retethered spinal cord after repair of lipomyelomeningocele"],"prefix":"10.3171","volume":"74","author":[{"given":"Hiroaki","family":"Sakamoto","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Hakuba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken","family":"Fujitani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuro","family":"Nishimura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"770","DOI":"10.3171\/jns.1971.34.6.0770","article-title":"Clinical results of lyophilized human cadaver dura transplantation.","volume":"34","author":"Abbott","year":"1971"},{"key":"b2","series-title":"Childs Brain","first-page":"192","article-title":"Spinal lipomas in infancy and childhood.","volume":"5","author":"Bruce","year":"1979"},{"key":"b3","series-title":"Childs Brain","first-page":"37","article-title":"Congenital intraspinal lipomas, Anatomic considerations and surgical treatment.","volume":"9","author":"Chapman","year":"1982"},{"key":"b4","series-title":"Dev Med Child Neurol (Suppl)","first-page":"62","article-title":"Lipomas of the cauda equina and other fatty tumours related to neurospinal dysraphism.","volume":"11","author":"Emery","year":"1969"},{"key":"b5","series-title":"Neuroorthopedics","first-page":"34","article-title":"Lumbo-sacral lipoma, the timing of the operation and morphological classification.","volume":"2","author":"Hakuba","year":"1986"},{"key":"b6","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/0090-3019(88)90181-4","article-title":"Diagnosis of tethered cords by magnetic resonance imaging.","volume":"30","author":"Hall","year":"1988"},{"key":"b7","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1148\/131.1.153","article-title":"Tethered cord syndrome following myelomeningocele repair.","volume":"131","author":"Heinz","year":"1979"},{"key":"b8","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3171\/jns.1985.62.1.0001","article-title":"Management of lipomyelomeningoceles. 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