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Long-segment type 1 split cord malformation with two-level split cord malformation and a single dural sac at the
Pankaj Kumar Singh1, Ashutosh Khandelwal, Ajit Singh
1Department of Neurosurgery, Cardiothoracic and Neurosciences Center, All India Institute of Medical Sciences, New Delhi, India. drpankajsingh11@gmail.com
Pediatric Neurosurgery
|January 4, 2012
Summary
This study reports a rare case of a long-segment, two-level split cord malformation with a single dural covering. Prophylactic surgery in this pediatric patient resulted in a good outcome, emphasizing its importance for preventing cord injury.
Area of Science:
- Neurosurgery
- Pediatric Neurology
- Spinal Cord Malformations
Background:
- Split cord malformation (SCM) is a rare congenital anomaly.
- Long-segment and multi-level SCM are exceptionally uncommon.
- Bony spurs associated with SCM, particularly with a single dural covering, are not well-documented.
Observation:
- A 1-year-old child presented with a dorsal hair tuft, scoliosis, and a low-lying conus medullaris.
- Imaging revealed a two-level type 1 split cord malformation (SCM) with bony spurs.
- The patient had no initial neurological deficits.
Findings:
- Surgical exploration identified two separate bony septae spanning multiple vertebral levels (D5-D9 and D11).
- The bony spurs were excised, and the filum terminale was sectioned.
- The patient experienced a favorable postoperative recovery.
Implications:
- This case underscores the potential for successful prophylactic surgical intervention in complex SCM cases.
- Meticulous surgical planning is crucial for managing long-segment and multi-level SCM.
- Early surgical management may prevent future neurological complications such as cord injury.
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