Dorsal bony spur in pediatric split cord malformations: eight-year experience from a tertiary care hospital.

Niveditha Manjunath, Amol Raheja, Sachin A Borkar, Ashok K Mahapatra, Deepak Gupta, Guru Dutta Satyarthee, Shashank S Kale
Author Information
  1. Niveditha Manjunath: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
  2. Amol Raheja: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
  3. Sachin A Borkar: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India. sachin.aiims@gmail.com.
  4. Ashok K Mahapatra: Institute of Medical Sciences and Sum Hospital, Bhubaneswar, Odisha, India.
  5. Deepak Gupta: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
  6. Guru Dutta Satyarthee: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
  7. Shashank S Kale: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.

Abstract

INTRODUCTION: Dorsal spurs in Type I split cord malformations (SCM-I) are infrequent findings. The pathogenesis of the same is debatable. The objective of this study is to analyze our experience with SCM-I patients having dorsal bony spurs.
METHODOLOGY: Retrospective analysis of SCM patients operated from 2010 to 2017 was performed. Their demographic profile, clinic-radiological features, operative findings, and outcome following surgery were recorded.
RESULTS: Twenty-four cases of Type I SCM harboring dorsal bony spurs were identified with mean age of 4.96 years. The commonest split site was lumbar, documented in 62.5%. Scoliosis was observed in 58.3%. Pre-operative neurological deficits were seen in 66.6% cases with asymmetric weakness of limbs seen in 16.6%. There was no new neurological deficit observed post-operatively.
CONCLUSIONS: This is the largest series of dorsal spurs occurring in SCM, reported in literature so far. Meticulous pre-operative evaluation and imaging are important to identify dorsal spurs for appropriate management and good clinical outcome. Differentiating dorsal spur from ventral spur is important as it has a bearing on surgical approach.

Keywords

References

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MeSH Term

Humans
Child
Child, Preschool
Retrospective Studies
Tertiary Care Centers
Neural Tube Defects
Radiography
Scoliosis
Spinal Cord
Magnetic Resonance Imaging

Word Cloud

Created with Highcharts 10.0.0spursdorsalSCMspurDorsalTypesplitcordbonymalformationsSCM-Ifindingsexperiencepatientsoutcomecasesobservedneurologicalseen6%importantINTRODUCTION:infrequentpathogenesisdebatableobjectivestudyanalyzeMETHODOLOGY:Retrospectiveanalysisoperated20102017performeddemographicprofileclinic-radiologicalfeaturesoperativefollowingsurgeryrecordedRESULTS:Twenty-fourharboringidentifiedmeanage496 yearscommonestsitelumbardocumented625%Scoliosis583%Pre-operativedeficits66asymmetricweaknesslimbs16newdeficitpost-operativelyCONCLUSIONS:largestseriesoccurringreportedliteraturefarMeticulouspre-operativeevaluationimagingidentifyappropriatemanagementgoodclinicalDifferentiatingventralbearingsurgicalapproachpediatricmalformations:eight-yeartertiarycarehospitalSplit

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