Vol 51, No 6 (2017)

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Surgical management of 142 cases of split cord malformations associated with osseous divide

Tao Wang1, Jian-Wen Gu1, Tie-Jun Shi1, Ke Li2, Wei Wang3, Xiao-Jun Bai1, Jun-Hai Zhang1, Zhi-Feng Yang1, Shao-Jie Cui1
DOI: 10.1016/j.pjnns.2017.07.013
Neurol Neurochir Pol 2017;51(6):459-464.

Abstract

Objectives

To investigate the key surgical points in treating split cord malformations associated with osseous divide and scoliosis (SCM-OD-S).

Materials and methods

The 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.

Results

The 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.

Conclusions

The 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.

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Neurologia i Neurochirurgia Polska