Tethered Spinal Cord, Including Thickened Filum, Lipomas, Myelomeningocele and Meningocele
Conditions
Keywords
Tethered spinal cord, pediatric neurosurgery, inflammation, procteomics
Brief summary
Embryologic phenomenons that lead to dysraphisms are known, but pathophysiology remains questioned. It is supposed not to be a simple mechanistic dysfunction, and other biological phenomenons are implied in spinal cord damaging. Two main hypothesis are that manual deformation of the cells and mitochondrial membranes lead to energy deficiency and blood flow changes. On the other hand, considering traumatic spinal cord injuries (SCI), inflammation has been shown to have dramatic effects on spinal cord function and physiology. Indeed, all essays about SCI have demonstrated that the initial trauma leads to mechanical injury to cells, accompanied by damages of microvasculature, initiation of pro-apoptotic signaling and ischemia. Therefore, we could imagine that similar inflammatory processes can be implied in stretched spinal cord. In our review of literature, we found few papers highlighting the question of inflammation and CSF sampling.
Interventions
PROCEDURECSF sampling during surgery
Proteomic studies will be led on the CSF samples, to identify inflammatory peptides and cells. The proteomic study will be correlated to clinical pre and post-operative data.
Sponsors
University Hospital, Lille
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
No minimum to 17 Years
Healthy volunteers
No
Inclusion criteria
* Infants and children under 18 years of age * Carriers of an attached marrow: lipomatous fiilum, meningocele, myelomeningocele, myelolipoma, * Consent of the child's parents, * Socially insured patient, * Patient willing to comply with all study procedures and duration,
Exclusion criteria
* Patients over 18 years of age, * Chronic inflammatory disease, * Ongoing anti-inflammatory treatments, * No parental consent,
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| To describe the markers of chronic inflammation present in CSF collected at the beginning of surgery in children with attached low marrow. | at the beginning of surgery | Proportion of patients with the presence of at least one marker of inflammation present in CSF collected at the beginning of surgery. |
Secondary
| Measure | Time frame |
|---|---|
| Proportion of patients with the presence of at least one marker of inflammation present in the CSF collected at the end of surgery. | at the end of surgery |
| Proportion of patients with the presence of at least one marker of inflammation present in the CSF collected at the beginning of surgery and the proportion of patients with the presence of at least one marker of inflammation at the end of surgery | at the end of surgery |
| The clinical outcome assessed by the NEM score in postoperative patients, immediately after surgery,3 months after surgery and 6 months after will be evaluated by the clinician in charge of the patient. | Immediately after surgery, 3 months after surgery and 6 months after surgery. |
| The NEM score measured preoperatively and immediately postoperatively | Just before and immediately after surgery. |
| The postoperative NEM score (immediately after surgery, 4 months after surgery and 18 months after) between patients with at least one of the inflammatory markers present and patients without inflammatory markers. | Immediately after surgery, 3 months after surgery and 6 months after surgery |
Countries
France
Outcome results
None listed