Split cord malformation(SCM)is a neural tube defect that the spinal cord is longitudinally separated into two hemicords with individual functions,which causes severe spinal cord impairment and sensorimotor deficit.As ...Split cord malformation(SCM)is a neural tube defect that the spinal cord is longitudinally separated into two hemicords with individual functions,which causes severe spinal cord impairment and sensorimotor deficit.As a kind of myelodysplasia and a special type of tethered cord syndrome,SCM is not widely understood,and common issues in the diagnosis and treatment of SCM should be clarified.In this paper,the Chinese Split Cord Malformation Working Group made a consensus for SCM on embryopathogenesis and types,clinical presentations,neuroimaging assessment,indications and principle of the surgery,surgical techniques and nuances,prognosis and follow up.展开更多
BACKGROUND Tethered cord syndrome(TCS) secondary to split cord malformation(SCM) is rare in adulthood.There is as yet no consensus about the optimal treatment method for adult patients with SCMs and degenerative spine...BACKGROUND Tethered cord syndrome(TCS) secondary to split cord malformation(SCM) is rare in adulthood.There is as yet no consensus about the optimal treatment method for adult patients with SCMs and degenerative spine diseases such as lumbar stenosis,spondylolisthesis and ossification of the ligamentum flavum(OLF).The tethered cord poses a great challenge to the decompression and fusion procedures for the intraoperative stretching of the spinal cord,which might lead to deteriorated neural deficits.Here,we report on a case to add our treatment experience to the medical literature.CASE SUMMARY We treated a 67-year-old female patient with type II SCM suffering from lumbar disc herniation,degenerative lumbar spondylolisthesis and thoracic OLF.The patient underwent thoracolumbar spinal fusion and decompression surgery for severe lower back pain,extensive left lower limb muscle weakness and intermittent claudication.After the thoracolumbar surgery,without stretching the tethered cord,the patient achieved complete relief of pain and lower extremity weakness at final follow-up.CONCLUSION For adult patients with underlying TCS secondary to SCM coupled with thoracic OLF and lumbar spondylolisthesis,a thoracolumbar fusion surgery could be safe and effective with the tethered cord untreated.It is critical to design individualized surgical protocols to reduce the stretch of the low-lying spinal cord.展开更多
文摘Split cord malformation(SCM)is a neural tube defect that the spinal cord is longitudinally separated into two hemicords with individual functions,which causes severe spinal cord impairment and sensorimotor deficit.As a kind of myelodysplasia and a special type of tethered cord syndrome,SCM is not widely understood,and common issues in the diagnosis and treatment of SCM should be clarified.In this paper,the Chinese Split Cord Malformation Working Group made a consensus for SCM on embryopathogenesis and types,clinical presentations,neuroimaging assessment,indications and principle of the surgery,surgical techniques and nuances,prognosis and follow up.
文摘BACKGROUND Tethered cord syndrome(TCS) secondary to split cord malformation(SCM) is rare in adulthood.There is as yet no consensus about the optimal treatment method for adult patients with SCMs and degenerative spine diseases such as lumbar stenosis,spondylolisthesis and ossification of the ligamentum flavum(OLF).The tethered cord poses a great challenge to the decompression and fusion procedures for the intraoperative stretching of the spinal cord,which might lead to deteriorated neural deficits.Here,we report on a case to add our treatment experience to the medical literature.CASE SUMMARY We treated a 67-year-old female patient with type II SCM suffering from lumbar disc herniation,degenerative lumbar spondylolisthesis and thoracic OLF.The patient underwent thoracolumbar spinal fusion and decompression surgery for severe lower back pain,extensive left lower limb muscle weakness and intermittent claudication.After the thoracolumbar surgery,without stretching the tethered cord,the patient achieved complete relief of pain and lower extremity weakness at final follow-up.CONCLUSION For adult patients with underlying TCS secondary to SCM coupled with thoracic OLF and lumbar spondylolisthesis,a thoracolumbar fusion surgery could be safe and effective with the tethered cord untreated.It is critical to design individualized surgical protocols to reduce the stretch of the low-lying spinal cord.
