Split cord malformations: from the surgical viewpoint

Abstract

Aims:Split cord malformations (SCM) are congenital anomalies of the spine. The spinal cord is divided into two hemicords in the vertical plane. With foot and spine deformities, the skin lesions on the midline, even at the level of the lesion, at the back are the main signs of SCM. It is divided into two types as Type I (Diastometamyelia) and Type 2 (Diplomyelia). We retrospectively reviewed our cases with SCM and presented our results.Methods:In our department, 27 cases of SCM in 2012-2018 were surgically treated. Of these, 23 were Type I, 4 were Type II. In type I SCM, the bone septum was removed, the hemicords were assembled in a single dura, and the spinal cord was released. In type II SCM, fibrous band was removed and spinal cord was released.Results:All patients were recovered well after surgery. No mortality had been occured. Cerebrospinal fluid (CSF) fistula was seen in 4 patients. The complications such as CSF fistula, infection or wound problems were properly managed. Conclusions:In this paper, we tried to mention about preoperative preparation, intraoperative surgical steps and postoperative period of SCMs. Surgical technique and steps were especially emphasized. SCMs should be treated surgically as soon as possible after the birth in order to avoid neurological and urological deterioration.