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Surgical management of 142 cases of split cord malformations associated with osseous divide
Affiliations- Department of Neurosurgery, The 306th Hospital of PLA, Beijing, China
- Department of Radiology, The 306th Hospital of PLA, Beijing, China
- Third Clinical College of Southern Medical University, Guangzhou, China
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Abstract
To investigate the key surgical points in treating split cord malformations associated with osseous divide and scoliosis (SCM-OD-S).
Materials and methodsThe surgical options and methods of a total of 142 SCM-OD-S cases were retrospectively analyzed, and the surgical precautions and imaging diagnosis were also discussed.
ResultsThe 142 patients were performed osseous divide resection plus dural sac molding, which achieved good results and no serious complication such as spinal cord and nerve injury occurred; certain symptoms such as urination-defecation disorders, muscle strength subsidence, Pes Cavus, and toe movement disorder in partial patients achieved various degrees of relief, and it also created good conditions for next-step treatment against scoliosis.
ConclusionsThe diagnosis of SCM-OD mainly depended on imaging inspection, routine magnetic resonance imaging (MRI) combined with computed tomography (CT) 3D reconstruction, which can comprehensively evaluate the types and features of diastematomyelia as well as other concomitant diseases. SCM alone needed no treatment, but surgery will be the only means of treating SCM-OD. Intraoperatively removing osseous divide step-by-step, as well as carefully freeing the spinal cord and remodeling the dural sac, can lay good foundations for relieving tethered cord, improving neurological symptoms, and further scoliosis orthomorphia, thus particularly exhibiting importance for the growth and development of adolescents.
Abstract
To investigate the key surgical points in treating split cord malformations associated with osseous divide and scoliosis (SCM-OD-S).
Materials and methodsThe surgical options and methods of a total of 142 SCM-OD-S cases were retrospectively analyzed, and the surgical precautions and imaging diagnosis were also discussed.
ResultsThe 142 patients were performed osseous divide resection plus dural sac molding, which achieved good results and no serious complication such as spinal cord and nerve injury occurred; certain symptoms such as urination-defecation disorders, muscle strength subsidence, Pes Cavus, and toe movement disorder in partial patients achieved various degrees of relief, and it also created good conditions for next-step treatment against scoliosis.
ConclusionsThe diagnosis of SCM-OD mainly depended on imaging inspection, routine magnetic resonance imaging (MRI) combined with computed tomography (CT) 3D reconstruction, which can comprehensively evaluate the types and features of diastematomyelia as well as other concomitant diseases. SCM alone needed no treatment, but surgery will be the only means of treating SCM-OD. Intraoperatively removing osseous divide step-by-step, as well as carefully freeing the spinal cord and remodeling the dural sac, can lay good foundations for relieving tethered cord, improving neurological symptoms, and further scoliosis orthomorphia, thus particularly exhibiting importance for the growth and development of adolescents.
Keywords
Split cord malformation, Scoliosis, Diagnosis, Surgery
About this articleTitle
Surgical management of 142 cases of split cord malformations associated with osseous divide
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
459-464
Page views
270
Article views/downloads
463
DOI
10.1016/j.pjnns.2017.07.013
Bibliographic record
Neurol Neurochir Pol 2017;51(6):459-464.
Keywords
Split cord malformation
Scoliosis
Diagnosis
Surgery
Authors
Tao Wang
Jian-Wen Gu
Tie-Jun Shi
Ke Li
Wei Wang
Xiao-Jun Bai
Jun-Hai Zhang
Zhi-Feng Yang
Shao-Jie Cui
