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ORIGINAL ARTICLE
Year : 2021  |  Volume : 8  |  Issue : 4  |  Page : 20-24

Split Cord Malformation: Our Experience


Department of Neurosurgery, VIMS and RC; Department of Neurosurgery, Vydehi Hospital, Bengaluru, Karnataka, India

Correspondence Address:
Arjun H Dev
Department of Neurosurgery, Vydehi Hospital, #82, EPIP Area, Whitefield, Bengaluru - 560 066, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joss.joss_2_21

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Background: Split cord malformation (SCM) is a rare form of neural tube defects. It belongs to closed type of neural tube defects. SCM constitutes around one-third of cases of spinal dysraphism. In SCM, there is a division in the spinal cord into two halves which may be equal or unequal. Objective: To analyse the clinical, radiological, intraoperative findings and surgical outcome of patients with SCM. Materials and Methods: This was a retrospective analysis of cases of SCM operated during 3-year period (2016–2019) in our institute. The data for the study were obtained from case records, operation notes, and radiology investigations. Results: There were 20 patients of spinal dysraphism in total, among which 6 cases were of SCM. All 6 cases were symptomatic with swelling in the back. Four had distal foot weakness, two had low backache, two had difficulty in walking, two had hypertrichosis, and one patient had foot deformity with trophic ulceration in the foot. Magnetic resonance imaging (MRI) revealed tethered cord in all 6 cases. Three had syringomyelia, three had lipomeningocele, and one case had intramedullary epidermoid. Computed tomography scan revealed bony spur in 4 cases. All patients underwent surgery. Conclusion: MRI is the investigation of choice and surgery is the treatment of choice. We have observed detethering done at the same sitting as that of the primary surgery has improved outcome. It also avoids the dilemma in attributing the postoperative neurological deficits if any, either to surgical complication or that due to tethered cord.


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