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Split cord malformation in adults: Literature review and classification
A Karim Ahmed1, Elizabeth P Howell2, Stephen Harward2
1Department of Neurosurgery. The Johns Hopkins School of Medicine, Baltimore, MD, USA.
Clinical Neurology and Neurosurgery
|March 9, 2020
Summary
Surgery significantly improves symptoms in adults with split cord malformations (SCM). This review of SCM Types I and II highlights operative benefits over conservative management for neurological deficits and pain.
Area of Science:
- Neurosurgery
- Developmental Biology
- Medical Literature Review
Background:
- Split cord malformations (SCM) are congenital anomalies.
- Types 1 and 2 SCM can present in adulthood with varied symptoms.
Purpose of the Study:
- To review literature on adult SCM presentation, diagnosis, and management.
- To analyze treatment outcomes for SCM Types I and II in adults.
Main Methods:
- Systematic literature search of CINAHL, PubMed, Embase, Web of Science.
- Inclusion of studies on adult SCM (diastematomyelia, diplomyelia, dimyelia).
- Analysis of 17 articles describing 146 adult patients.
Main Results:
- Tethered cord syndrome was the most common associated condition (59.8%).
- Operative management was performed in 72.3% of symptomatic cases.
- Surgery led to significant improvement in 96.6% with neurological deficits and 91.1% with pain, versus 0% and 12.5% for conservative care, respectively.
Conclusions:
- Operative management is highly effective for symptomatic adult SCM.
- Early surgical intervention may prevent long-term neurological deficits.
- This review provides comprehensive data on adult SCM outcomes.
