Spinal Dysraphism in Adults

Adult patients with spinal dysraphism include those with new symptomatic onset of a previously unsuspected occult dysraphic condition and those with a known dysraphic lesion in childhood but with symptom onset only in adulthood. In both groups, unlike in childhood, pain is the most frequent presenting symptom. This may be poorly localized and bilateral, and coupled with weakness in the legs as well as sensory disturbance. Problems with bladder control, as well as erectile dysfunction, also occur frequently. Not infrequently, the problem only comes to light as a result of excessive stretching of the conus, as may occur in childbirth or trauma [25]. In those with a known dysraphic lesion, presentation in adulthood may be with a progressive scoliosis or foot deformity, although these features are generally not seen in an adult with a previously unsuspected dysraphism.

There is often no cutaneous clue to an underlying dysraphic lesion, which may take the form of a thickened or tight filum, or an intradural lipoma, as well as containing dermoid material.

As for childhood dysraphism, surgical untethering is recommended for symptomatic adults. This usually involves division of the filum or release of adhesion and debulking of a lipoma.

Pang and Wilberger [25] have reported very satisfying improvements in pain following

Cure Your Yeast Infection For Good

Cure Your Yeast Infection For Good

The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.

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