{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:28:09Z","timestamp":1776990489549,"version":"3.51.4"},"reference-count":18,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2007,9]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The goal of the present study goal was to systematically confirm the previously recognized nomenclature for tethering tracts that are part of the spectrum of occult spinal dysraphic lesions.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The tethering tract in 20 patients with spina bifida occulta underwent histological examination with H &amp; E staining and epithelial membrane antigen (EMA) immunolabeling, and additional selected specimens were stained with Masson trichrome.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>All tethering tracts contained fibrous connective tissue. Four tracts were lined with epithelial cells and either originated within a dermoid cyst, terminated at a skin dimple\/sinus opening, or had both of these characteristics. No tethering tracts exhibited EMA positivity or meningeal elements. Although all tethering tracts originated in juxtaposition to the spinal cord, their termination sites were variable.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Based on histological findings and presumed embryological origin, the authors broadly classified tethering tracts terminating within the dura mater, epidural space, or lamina as \u201cshort tethering tracts\u201d (STTs). The STTs occurred mostly in conjunction with split cord malformations and had a purely fibrous composition. Tethering tracts terminating superficial to the overlying lamina were classified as \u201clong tethering tracts\u201d (LTTs), and the authors propose that these are embryologically distinct from STTs. The LTTs were of two varieties: epithelial and nonepithelial, the former being typically associated with a skin dimple or spinal cord (epi)dermoid cyst. In fact, analysis of the data suggested that not every tethering tract terminating in or on the skin should be classified as a dermal sinus tract without histological confirmation, and because no evidence of meningeal tissue\u2013lined tracts was detected, the use of the term \u201cmeningocele manqu\u00e9\u201d may not be appropriate.<\/jats:p><\/jats:sec>","DOI":"10.3171\/spi-07\/09\/315","type":"journal-article","created":{"date-parts":[[2008,1,24]],"date-time":"2008-01-24T12:23:52Z","timestamp":1201177432000},"page":"315-322","source":"Crossref","is-referenced-by-count":36,"title":["Tethering tracts in spina bifida occulta: revisiting an established nomenclature"],"prefix":"10.3171","volume":"7","author":[{"given":"Sharad","family":"Rajpal","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Shahriar","family":"Salamat","sequence":"additional","affiliation":[{"name":"Pathology, University of Wisconsin Hospitals and Clinics, Madison, Wisconsin;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. Shane","family":"Tubbs","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, University of Alabama at Birmingham; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David R.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Pathology, Children's Hospital, Birmingham, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W. Jerry","family":"Oakes","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, University of Alabama at Birmingham; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bermans J.","family":"Iskandar","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-0070315","series-title":"Pediatrics","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1542\/peds.112.3.641","article-title":"Spinal congenital dermal sinuses: a 30-year experience","volume":"112","author":"Ackerman","year":"2003"},{"key":"b2-0070315","series-title":"Pediatr Neurosurg","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1159\/000064399","article-title":"Cervical and thoracic dermal sinus tracts. 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