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Management of split cord malformation in children: the Lyon experience

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A Correction to this article was published on 17 May 2018

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Abstract

Introduction

Split cord malformation (SCM) is a rare congenital spinal abnormality. Clinical presentation varies. Other congenital defects can be associated. Management is surgical.

Material and methods

We retrospectively reviewed all our SCM cases and reported our experience for its management. From 1990 to 2014, 37 patients were operated. Five situations lead to the diagnosis (orthopedic disorders (n = 8), orthopedic and neurological disorders (n = 16), pure neurological disorders (n = 5), no symptoms except cutaneous signs (n = 7), antenatal diagnosis (n = 1)). Scoliosis was the most common associated condition. The level of the spur was always under T7 except in one case. There were more type I (n = 22) than type II (n = 15) SCM.

Results

Patients with preoperative neurological symptoms (n = 21) were improved in 71.4%. Five out of nine patients that had preoperative bladder dysfunction were improved. Eleven patients needed surgical correction of the scoliosis.

Conclusions

For us, the surgical procedure is mandatory even in case of asymptomatic discovery in order to avoid late clinical deterioration. In any case, the filum terminale need to be cut in order to untether completely the spinal cord. In case a surgical correction of a spinal deformity is needed, we recommend a two-stage surgery, for both SCM type. The SCM surgery can stop the evolution of the scoliosis and it may just need an orthopedic treatment with a brace.

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Change history

  • 17 May 2018

    The original version of this article unfortunately contained an error. The authors have been published with inverted given and family names. Given in this article are the corrected author names.

Abbreviations

CSF:

Cerebro spinal fluid

CT scan:

computed tomography scanner

DM:

Diplomyelia

DSM:

Diastematomyelia

MM:

Myelomeningocele

MRI:

Magnetic resonance imaging

SCM:

Split cord malformation

US:

Ultrasound scan

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Authors and Affiliations

  1. Department of Pediatric Neurosurgery, Hôpital Femme Mère Enfant, Hospice Civil de Lyon, 59 Boulevard Pinel, 69677, Lyon Cedex, France

    Beuriat Pierre-Aurelien, Di Rocco Federico, Szathmari Alexandru & Mottolese Carmine

Authors
  1. Beuriat Pierre-Aurelien
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  2. Di Rocco Federico
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  3. Szathmari Alexandru
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  4. Mottolese Carmine
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Corresponding author

Correspondence to Mottolese Carmine.

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Conflict of interest

The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors

Electronic supplementary material

supplement digital content 1

surgical technique to remove the bony spur (0:02: dissection of the spur; 0:14 coagulation of the veins and arteries; 0:23: removal of the spur) (MOV 255506 kb)

supplement digital content 2

surgical technique to reconstructed a single dural sac (0:01: opening of the dura; 0:10 closure of the dura; 0:31: one single dural sac is obtained) (MOV 351658 kb)

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Pierre-Aurelien, B., Federico, D.R., Alexandru, S. et al. Management of split cord malformation in children: the Lyon experience. Childs Nerv Syst 34, 883–891 (2018). https://doi.org/10.1007/s00381-018-3772-3

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  • DOI: https://doi.org/10.1007/s00381-018-3772-3

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