Split cord malformation associated with spinal open neural tube defect

Area of Science:

• Neurology
• Pediatric Surgery
• Radiology

Background:

• Split cord malformation (SCM) is a complex congenital spinal anomaly.
• Spinal open neural tube defects (SONTD) represent a spectrum of developmental abnormalities.
• The co-occurrence of SCM and SONTD requires careful characterization.

Purpose of the Study:

• To delineate the clinical and radiological features of SCM in patients with SONTD.
• To evaluate the treatment outcomes for SCM associated with SONTD.

Main Methods:

• Retrospective analysis of 11 SCM patients among 83 SONTD cases.
• Data collected from King Khalid University Hospital (1995-2010).
• Clinical and imaging (CT, MRI) findings were reviewed, alongside Frankel grading.

Main Results:

• The study included 6 girls and 5 boys (age range: <1 to 9 years).
• Six patients had Type I SCM, and 5 had Type II SCM.
• Imaging revealed characteristic septa and associated SONTD anomalies. 7/11 patients (Frankel A/B) did not require surgery; 3/11 with neurological decline improved post-surgery; 1/1 remained stable after cord untethering.

Conclusions:

• SCM is a notable finding in SONTD patients, often affecting the lumbar spine.
• Female predominance was observed in Type I SCM.
• Neurological symptoms in SCM can be superimposed on SONTD, with surgery benefiting symptomatic individuals but not the severely disabled.