Profile of paediatric patients with split cord malformation

Abstract

AimTo present a case series of pediatric
patients with split cord malformations ,
and to discuss the clinical presentations,
radiological findings and the management.
MethodsAll patients with age less
than 18 years with clinical or radiological
features of split cord malformations who
had been admitted during march 2008 to
march 2011 at madras institute of neurology
were included in this study. 27 patients
among the age group ranging from
1yr 3months to 16 yrs age were studied.
12 males and 15 females, with 25 patients
having type I(pang classification)
and 2 having type 2 split cord malformations.
16 patients had cutaneous stigmata.
11patients had orthopaedic problems.
5 patients had both. Back pain and
leg pains were seen in 12 patients.
15patients had motor involvement,
12 had sensory involvement and 10 had
bladder involvement. 4 patients were without
any neurological deficit. 7 patient had
split cord at the lumbar level and 7 patient
had in the thoracic level, 13 had dorsolumbar
region. MRI scan revealed associated
dermal sinus tract, epidermoids , lipoma
and thickenened filum terminale . Detethering
procedure had been done in all patients
depending upon the type of tethering. Associated
anomalies were also addressed.
Follow up neurological examination
was done at 3 and 6 months interval.
Results18 patients experienced better
or stable neurological status, 7 patient did
not show any improvement in bladder function,
1 patient had worsening in neurological
status 1 patient developed hydrocephalus
for which ventriculoperitoneal shunt was done