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Year : 2006  |  Volume : 1  |  Issue : 3  |  Page : 5-9

Split cord malformations

Department of Neurosurgery, Manipal Institute for Neurological Disorders (MIND), Bangalore, India

Correspondence Address:
N K Venkataramana
Department of Neurosurgery, Manipal Institute for Neurological Disorders, Airport Road,Bangalore - 560 017
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Source of Support: None, Conflict of Interest: None

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Split cord malformations (SCM) are increasingly being recognized as one of the causes of tethered cord syndrome. Renaming them as SCMs has reduced the conflict in terminology, though the pathogenesis of these complex anomalies still remains controversial. The diagnosis has become easy and certain with the advent of magnetic resonance imaging (MRI). It is necessary to screen the entire spine in order to recognize all the associated anomalies and to plan the management strategies. Aim: To study the role of prophylactic surgery in patients with SCM. Settings and Design: Retrospective clinical analysis. Methods and Material: In a series of 217 children treated with spinal dysraphism from 1994 to 2004 at Manipal Institute for Neurological disorders (MIND), 38 had SCMs and the clinical presentation and surgical outcome was retrospectively analyzed. Statistical analysis used Results: 34 children had isolated SCM, four children had other complex congenital anomalies. 23 children [type 1-18 (47%) and type 2-20 (53%)] were operated prophylactically. They maintained neurological stability after surgery. Among the children with pre-existing neurological deficits, stability was achieved in all and significant improvement in only 8%. Outcome was better in isolated SCM in compression to complex ones. Conclusion: We recommend surgery before the onset of neurological deficits. Surgical results are excellent with good microsurgical technique


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