Surgical Treatment of Split Cord Malformations (SCM) In Children

Background: Split cord malformation (SCM) is a term used for diastematomyelia and diplomyelia. Its incidence is decreasing in the world literature. Objective: This study aims at evaluating the outcome of surgery for SCM in eleven children operated upon at the Neurosurgery Department of Benha University Hospitals and at the Benha Specialized Children Hospital between March 2013 and June 2015. Patients and Methods: This prospective clinical cohort study includes eleven patients, five boys and six girls, with age ranging from one day to twelve years ((38.2 months ±6.7 SD) and magnetic resonance imaging (MRI) -proven SCM. Results: all six patients with back/leg pain recovered completely as regard leg pain and improved as regard the back pain. The two patients with numbness/parathesias also improved greatly. Two of the three patients with leg weakness were neurologically stable while one patient, operated upon at the age of 11 days for SCM associated with meningiomyelocele, returned with retethering, proved on re-exploration to be due to arachnoid scarring. All six patients with no neurologic deficit showed no neurological deterioration. In six patients pre- and postoperative urodynamic studies were performed and showed no great change. Conclusion: We recommend early surgery for SCM to avoid or minimize the suspected neurologic deficit. Outcome of the patients with SCM is generally gratifying. All the tethering elements must be taken care of to release the spinal cord.