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Peer reviews were done on the articles: Diane Barber (author-Mcavrak) and Recetopr activated solely by synthetic ligand (author-Bdyoung)

1) https://reader.elsevier.com/reader/sd/pii/S0899707118302031?token=5BFE87CA9BB4AE26DA50C1683E39F7894E8CC8193CD723CE6D4EA7C7DF3B7315BDD435E6B00D2DA4D6C81FC3CBB7E029  (This source can be used for imaging or to add a figure)

Diseases

2) John P Mcgahan, Gianluigi P, David A. Nyberg: Neural tube defects and the spine: Diagnostic imaging of fetal anomalies. 1st ed. Lippincott: Williams & Wilkins, 2003; 7:321-3.

15) R.J. Lemire, Variations in development of the caudal neural tube in human embryos (Horizons XIV–XXI), Teratology 2 (1969) 361– 369

16) F. Muller, R. O’Rahilly, The development of the human brain, the closure of the caudal neuropore, and the beginning of secondary neurulation at stage 12, Anat. Embryol. 176 (1987) 413–430.

Caudal Cell Mass

The caudal end of the spinal cord first begins to form after primary neuralation has taken place, indicating that it develops after the cranial portion of the spinal cord has developed. Following neuralation, the caudal tail begins to form a neurocele as it develops a hollow core. After this, secondary neuralation occurs in which the medullary cord begins to form and is filled with many cavities that ultimatelly form the lumen. The cavities formed from the initial and secondary neuralation combine to form one uninterrupted cavity. . There is still specualtion on the formation of the caudall cell mass in humans with arguments being made for it arising from many cavities or the continuing growth of the neurocele from the initial neuralation. The caudal cell mass will ultimately differentiate and form into many sacral structures such various nerve endings and the conus medullaris.

Role in Disease
The caudal cell mass plays a role in many diseases and abnomalities related to the spinal cord. One group of abnormalities it plays a role in are occult spinal dysraphisms. These types of abnormalities arise from specific structures formed in the caudal mass, for example if proper differentiation of the caudal mass doesn't occur, it could result in a type of spinal dysraphism. One example of spinal dysraphism is caudal regression syndrome.Patients suffering from caudal regression syndrome can experience a varying degree of the abnormality ranging from partial lack of the tail bone and pelvis to more significant cases where there may be paralysis and, as a result, inhibited function in the bowel and bladder. This abnormality can be caused by the caudal cell mass not developing properly due to improper differentiation, and it can lead to sacral agenesis, which is one of the hallmarks of caudal regression syndrome.

Another class of abnormalities caudal cell mass development includes caudal dysgenesis, which refers to abnormalities where the sacrum may be deformed or absent, or abnormalities in which the spinal cord and the complemetary organ systems may be malformed. Some of the abnormalities that fall under this class includes currarino syndrome and sirenomelia. These genetic defects were found to have a much higher rate of incidence in births to mothers with gestational diabetes. This trend may be due to the inhibition of critical elements of morphogenesis, that are found in the extracellular matrix, or due to the presence of an abnormal hox gene. These abnormalities can be predicted ahead of time using ultrasound.