Pediatric Spinal Dysraphisms, Tethered Cord Syndrome and Scoliosis: Controversies, Recent Advances, and Future Challenges

Dear Colleagues,

Pediatric spinal disorders constitute some of the most clinically complex and impactful challenges in pediatric neurosurgery and orthopedics. Many of the common spinal conditions treated in pediatric neurosurgery such as Chiari malformation, spinal dysraphism or tethered cord syndrome, as well as more rare conditions such as VACTERL and sacral agenesis, can profoundly affect children from infancy through adolescence, often resulting in significant consequences for neurological function, musculoskeletal development, and overall quality of life. Importantly, many such conditions not only directly affect the spinal cord itself but also influence the development and stability of the osseous spine as well. Chiari malformation, for example, has been closely associated with cranio-cervical junction pathology including platybasia, basilar invagination and odontoid retroflexion. Similarly, spinal dysraphisms and tethered cord syndrome have been closely linked to both congenital and idiopathic scoliosis, while myelomeningocele can result in gibbus deformity or neuromuscular scoliosis. On routine MRI screening, intraspinal anomalies can be found in 6.8-18% of patients with idiopathic scoliosis and 20-40% of patients with congenital scoliosis. Despite extensive research, the complex interaction of genetic, biomechanical, hormonal and environmental factors renders the management of these conditions a continually evolving process. However, the field is poised for innovation. This Special Issue seeks to present and disseminate the latest advances in the diagnosis, surgical management and long-term outcomes of pediatric spinal disorders. We welcome contributions focused on clinical research, surgical techniques, imaging innovations and outcome analyses across the spectrum of pediatric spinal pathologies, with specific emphasis on how these pathologies interact with cranio-cervical instability or scoliosis.

Topics of interest for publication include, but are not limited to, the following:

• Open and closed spinal dysraphism
• Tethered cord syndrome: clinical presentation, indications for untethering and recurrence
• Syringomyelia and Chiari malformation associated with spinal cord tethering
• Sacral agenesis and caudal regression syndrome
• Intraspinal anomalies and adolescent/congenital scoliosis
• Neuromuscular scoliosis in setting of myelomeningocele
• Cranio-cervical instability in setting of Chiari malformation
• Three-dimensional imaging, CT/MRI advances and preoperative planning tools
• Health-related quality of life and patient-reported outcomes in pediatric spinal disease
• Multidisciplinary care models and rehabilitation in spinal dysraphism.

Dr. Taemin Oh
Guest Editor

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• pediatric spine
• scoliosis
• cervical instability
• spinal dysraphism
• tethered cord syndrome
• myelomeningocele
• neural tube defects
• spinal cord malformations
• spinal column shortening