{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T10:49:08Z","timestamp":1782211748612,"version":"3.54.5"},"reference-count":58,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2005,10]]},"abstract":"\n \n Object<\/jats:italic>\n <\/jats:title>\n A terminal myelocystocele is a rare form of spinal dysraphism in which the hydromyelic caudal spinal cord and the subarachnoid space are herniated through a posterior spina bifida. In their study of 17 cases, the authors attempt to develop treatment guidelines for patients suffering from this condition.<\/jats:p>\n <\/jats:sec>\n \n \n Methods<\/jats:italic>\n <\/jats:title>\n Seventeen patients (age range 2 months\u20135 years) underwent surgery during a 7-year period. Surprisingly, nine of 17 patients had no neurological deficits. Among these nine asymptomatic cases, three patients had a dermal sinus and two had a skin dimple, whereas one had congenital talipes equinovarus deformity (CTEV). Among the eight patients with neurological deficits, seven had lower-limb weakness (two had complete paraplegia), and one patient had urinary incontinence and constipation. Four patients each had a dermal sinus and CTEV; interestingly, one infant had an accessory phallus. Radiologically, eight patients had pure myelocystoceles, and a diagnosis of lipomyelocystocele was made in nine instances on the basis of magnetic resonance images. All patients underwent surgery. The meningocele sacs were excised, and the bands tethering the myelocystocele sac to the meningocele sacs were incised, with as little damage to the roots as possible. Two patients experienced postoperative CSF leakage (one required reexploration), and two others had subcutaneous CSF collection. No patient had deterioration of the neurological condition after surgery.<\/jats:p>\n <\/jats:sec>\n \n \n Conclusions<\/jats:italic>\n <\/jats:title>\n The authors present the largest study of patients with terminal myelocystocele to date and emphasize that the possibility of this condition must be kept in mind when addressing all congenital lumbosacral masses. The authors assert that myelocystoceles and lipomyelocystoceles should be kept in the same category and recommend early surgery in all cases.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/ped.2005.103.4.0344","type":"journal-article","created":{"date-parts":[[2010,8,27]],"date-time":"2010-08-27T06:02:54Z","timestamp":1282888974000},"page":"344-352","source":"Crossref","is-referenced-by-count":13,"title":["Terminal myelocystoceles: a series of 17 cases"],"prefix":"10.3171","volume":"103","author":[{"given":"Deepak Kumar","family":"Gupta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashok K.","family":"Mahapatra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Pediatric Neuroimaging: Contemporary Neuroimaging.","first-page":"227","article-title":"Congenital anomalies of the spine","volume":"1","author":"Barkovich","year":"1990"},{"key":"b2","series-title":"Birth Defects Orig Artic Series","first-page":"253","article-title":"The OEIS complex (omphalocele, exstrophy, imperforate anus, spinal defects).","volume":"14","author":"Carey","year":"1978"},{"key":"b3","series-title":"Pediatr Neurosurg","first-page":"83","article-title":"Terminal myelocystocele: an unusual presentation.","volume":"32","author":"Cartmill","year":"2000"},{"key":"b4","series-title":"Neurosurgery","first-page":"834","article-title":"The mermaid malformation: cloacal exstrophy and occult spinal dysraphism.","volume":"28","author":"Cohen","year":"1991"},{"key":"b5","series-title":"Childs Nerv Syst","first-page":"165","article-title":"Cervical meningocele and associated spinal anomalies.","volume":"3","author":"Delashaw","year":"1987"},{"key":"b6","series-title":"Childs Nerv Syst","first-page":"487","article-title":"Is meningocele really an isolated lesion?","volume":"17","author":"Er\u015fahin","year":"2001"},{"key":"b7","series-title":"Clin Neurosurg","first-page":"295","article-title":"The embryology of spinal dysraphism.","volume":"30","author":"French","year":"1983"},{"key":"b8","series-title":"Am J Dis Child","first-page":"879","article-title":"Exstrophy of the cloaca.","volume":"125","author":"Hayden","year":"1973"},{"key":"b9","series-title":"Indian J Pediatr","first-page":"342","article-title":"Spinal lipomatous malformations.","volume":"67","author":"Jindal","year":"2000"},{"key":"b10","series-title":"Neurological Surgery","first-page":"861","article-title":"Lipomyelomeningocele and myelocystocele","author":"Kanev","year":"1996"},{"key":"b11","series-title":"Indian J Pediatr","first-page":"1083","article-title":"Terminal myelocystocele.","volume":"69","author":"Kumar","year":"2002"},{"key":"b12","series-title":"J Pediatr","first-page":"948","article-title":"Skin-covered sacrococcygeal masses in infants and children.","volume":"79","author":"Lemire","year":"1971"},{"key":"b13","series-title":"Normal and Abnormal Development of the Human Nervous System.","first-page":"71","article-title":"Secondary caudal neural tube formation","year":"1975"},{"key":"b14","series-title":"Progress in Clinical Neurosciences.","first-page":"91","article-title":"Lipomyelomeningocele\u2014a clinical challenge","volume":"17","author":"Mahapatra","year":"2002"},{"key":"b15","series-title":"Pediatric Neurosurgery: Surgery of the Developing Nervous System","first-page":"3","article-title":"Normal and abnormal early development of the nervous system","author":"McLone","year":"1994"},{"key":"b16","series-title":"Neurosurgery","first-page":"36","article-title":"Terminal myelocystocele.","volume":"16","author":"McLone","year":"1985"},{"key":"b17","series-title":"Radiology.","first-page":"100","article-title":"Congenital pathology of the spine and spinal cord","author":"Naidich","year":"1986"},{"key":"b18","series-title":"Neurosurgery","first-page":"755","article-title":"Sacral agenesis and caudal spinal cord malformations.","volume":"32","author":"Pang","year":"1993"},{"key":"b19","series-title":"J Neurosurg","first-page":"804","article-title":"Magnetic resonance imaging in myelocystoceles. 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Report of two cases.","volume":"70","author":"Peacock","year":"1989"},{"key":"b20","series-title":"Br J Urol","first-page":"31","article-title":"A case of complicated extrophy of the bladder presenting many unusual features.","volume":"11","author":"Russell","year":"1939"},{"key":"b21","series-title":"Brain Dev","first-page":"469","article-title":"Unusual split of the spinal cord in a caudal regression syndrome with myelocystocele.","volume":"4","author":"Schmitt","year":"1982"},{"key":"b22","series-title":"Teratology","first-page":"103","article-title":"Morphogenesis of malformations in hamsters caused by retinoic acid: relation to dose and stage at treatment.","volume":"5","author":"Shenefelt","year":"1972"},{"key":"b23","series-title":"J Korean Med Sci","first-page":"197","article-title":"Terminal myelocystocele\u2014a case report.","volume":"11","author":"Sim","year":"1996"},{"key":"b24","series-title":"Neurosurg Clin N Am","first-page":"367","article-title":"Dysraphic lesions of the cervical spinal cord.","volume":"6","author":"Steinbok","year":"1995"},{"key":"b25","series-title":"Pediatr Neurosurg","first-page":"317","article-title":"Cervical meningoceles and myelocystoceles: a unifying hypothesis.","volume":"23","author":"Steinbok","year":"1995"},{"key":"b26","series-title":"J Neurosurg","first-page":"206","article-title":"The nature of congenital posterior cervical or cervicothoracic midline subcutaneous mass lesions. Report of eight cases.","volume":"75","author":"Steinbok","year":"1991"},{"key":"b27","series-title":"J Neurosurg","first-page":"392","article-title":"Myelocystocele with cerebellar heterotopia. 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