Profile of paediatric patients with split cord malformation                                    Manoranjithakumari M, Rames...
neurological findings:Motor findings                      15       55%Sensory symptoms                    12      44.44%Bl...
Surgery                                                   CasesLaminotomy and excision of bony spur                      2...
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Split cord malformation

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Split cord malformation

  1. 1. Profile of paediatric patients with split cord malformation Manoranjithakumari M, Ramesh VG, Sundar VAim Study DesignTo present a case series of pediatric patients This study is a retrospective analysis of patients whowith split cord malformations, and discuss the had been admitted with SCM between march 2008 toclinical presentations, radiological findings and march 2011 in Institute of Neurology, Madras Medicalmanagement College. Clinical profile, neurological findings, radiological finding, surgery and the outcome wereTotal cases 27 Male:Female 1:1.25m analysed. Patients with a demonstrated open neuralmale 12 Type I 25 92.59% tube defect were excluded. Only those with at least 6Female 15 TypeII 2 7.40% months of follow-up data were included. Presenting signs and symptoms Neuro orthopaedic syndrome 11 40.74% Scoliosis 9 33.33% Club foot 7 25.92%limb length discrepancy hemangioma Congenital dislocation of hip 2 7.4% Limb length discrepency 5 18.51% Cutaneous stigmata 16 59.26% Hypertrichosis 12 44.44% Lipoma 6 22.22% Dermal sinus tract 4 14.81% scoliosis hypertrichosis Hemangioma 3 11.11
  2. 2. neurological findings:Motor findings 15 55%Sensory symptoms 12 44.44%Bladder incontinence 10 37%Pain 8 30%No deficit 4 14.8% LevelDorsal 7 25.9%Lumbar 7 25.9%Dorso lumbar 13 48.2% tandem pathological lesions:Lipomeningocele 3 11.11%Dermal sinus tract 4 4.8%Epidermoid 2 7%Thickened filum 8 9.6%
  3. 3. Surgery CasesLaminotomy and excision of bony spur 2Laminectomy and excision of bony spur 21Laminectomy and excision of fibrous septa 2Re exploration and release of thickened filum terminale 2Excision of lipoma 3Excision of epidermoid 2Excision of dermal sinus tract 4 Results (6 months follow up) CasesRelease of thickened filum terminale 6 Improvement 18 Complications Cases No improvement 7 Pseudomeningocele 3 Deterioration 1 Hydrocephalus 1 Hydrocephalus (shunted) 1 5 patients underwent scoliosis correction Conclusion All cases with simple and recent deficits showed good recovery with early surgery. However complex cases had delayed or less recovery. We recommend early surgery in all patients with split cord malformation before the onset of neurological deficit.
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