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The effect of surgery for split spinal cord malformation on neurologic and urologic function
M R Proctor1, S B Bauer, R M Scott
1Department of Neurosurgery, Children's Hospital, Harvard Medical School, Boston, MA 02115, USA. proctor_m@a1.tch.harvard.edu
Pediatric Neurosurgery
|April 15, 2000
Summary
Split spinal cord malformation (SSCM) often causes hidden urinary dysfunction. Urodynamic studies revealed that 73% of patients had voiding issues, even without symptoms, highlighting the importance of testing.
Area of Science:
- Neuroscience
- Urology
- Pediatric Surgery
Background:
- Split spinal cord malformation (SSCM) is a type of occult spinal dysraphism.
- SSCM can lead to spinal cord tethering, potentially affecting neurological function.
Purpose of the Study:
- To investigate the prevalence of urologic dysfunction in patients with SSCM.
- To determine the utility of urodynamic studies (UDS) in evaluating and managing these patients.
Main Methods:
- Retrospective analysis of 15 patients with SSCM (without open neural tube defects).
- Pre- and postoperative urodynamic studies (UDS) were performed on all patients.
- Patients were reviewed regardless of presenting age or overt urologic symptoms.
Main Results:
- Despite the absence of preoperative urologic symptoms in most patients, 73% exhibited voiding abnormalities on formal UDS.
- UDS provided objective data for perioperative management and surgical decision-making.
- Postoperative UDS helped assess surgical success and diagnose suspected retethering.
Conclusions:
- A significant percentage of patients with SSCM experience urologic dysfunction, often asymptomatic.
- Urodynamic studies are crucial for diagnosing and managing urinary issues in SSCM patients.
- UDS aids in evaluating surgical outcomes and monitoring for spinal cord retethering.