Intradural spinal endoscopy in children

Report of 4 cases

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Intracranial endoscopy in the treatment of hydrocephalus, arachnoid cysts, or brain tumors has gained wide acceptance, but the use of endoscopy for intradural navigation in the pediatric spine has received much less attention. The aim of the authors' present study was to analyze their experience in using spinal endoscopy to treat various pathologies of the spinal canal.

The authors performed a retrospective review of intradural spinal endoscopic cases at their institution. They describe 4 representative cases, including an arachnoid cyst, intrinsic spinal cord tumor, holocord syrinx, and split cord malformation.

Intradural spinal endoscopy was useful in treating the aforementioned lesions. It resulted in a more limited laminectomy and myelotomy, and it assisted in identifying a residual spinal cord tumor. It was also useful in the fenestration of a multilevel arachnoid cyst and in confirming communication of fluid spaces in the setting of a complex holocord syrinx. Endoscopy aided in the visualization of the spinal cord to ensure the absence of tethering in the case of a long-length Type II split spinal cord malformation.

Conclusions

Based on their experience, the authors found intradural endoscopy to be a useful surgical adjunct and one that helped to decrease morbidity through reduced laminectomy and myelotomy. With advances in technology, the authors believe that intradural endoscopy will begin to be used by more neurosurgeons for treating diseases of this anatomical region.

Article Information

Address correspondence to: R. Shane Tubbs, M.S., P.A.-C., Ph.D., Children's Hospital ACC 400, 1600 7th Avenue South, Birmingham, Alabama 35233. email: shane.tubbs@chsys.org.

© AANS, except where prohibited by US copyright law.

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Figures

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    Case 3. Internal view of the holocord syrinx.

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    Case 4. Inspection of the dorsal surface of spinal cord for tethering in a child with split cord malformation. The image was taken with a NeuroPEN endoscope. Notice the segmental appearance of the existing nerve roots and the rotation of the spinal cord in the axial plane due to the scoliosis.

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