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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...

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Split cord malformations: A two years experience at AIIMS.

Sachin A Borkar1, A K Mahapatra

  • 1Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.

Asian Journal of Neurosurgery
|August 8, 2012
PubMed
Summary
This summary is machine-generated.

Split cord malformation (SCM) is uncommon, with surgical outcomes varying by type. The Mahapatra and Gupta subclassification system effectively predicts neurological deterioration in Type I SCM patients.

Keywords:
Spinal dysraphismsplit cord malformationunified theory

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Area of Science:

  • Neurosurgery
  • Pediatric Neurosurgery
  • Spinal Dysraphism

Background:

  • Split cord malformation (SCM) is a rare congenital anomaly of the spinal cord.
  • This study analyzes 53 SCM cases treated over two years at a single institution.
  • SCM represented 27% of all spinal dysraphism surgeries during the study period.

Purpose of the Study:

  • To retrospectively analyze the clinical features, radiological findings, and surgical outcomes of SCM patients.
  • To evaluate the prognostic value of the Mahapatra and Gupta subclassification system for Type I SCM.

Main Methods:

  • Retrospective review of 53 SCM patient case files, operation notes, and follow-up records.
  • Clinical assessment, spinal deformity evaluation (scoliosis, kyphosis), and Magnetic Resonance Imaging (MRI).
  • Surgical intervention for all patients, with post-operative neurological assessment and follow-up MRI.

Main Results:

  • 30 cases of Type I and 23 cases of Type II SCM were identified.
  • Common associated findings included bony spinal deformity (24%), foot deformity (10%), hypertrichosis (13%), and dermal sinus (4%).
  • Post-operative neurological deterioration occurred in 15% of patients, with 7% experiencing long-term deficits, primarily in Type Id SCM.

Conclusions:

  • SCM is an uncommon condition requiring careful surgical management.
  • MRI is crucial for diagnosing SCM and associated conditions like syringomyelia, especially in progressive scoliosis.
  • The Mahapatra and Gupta subclassification system demonstrated significant prognostic value for Type I SCM, aiding in predicting post-operative outcomes.