Akiyama Katsuhiko, Nishiyama Kenichi, Yoshimura Junichi, Mori Hiroshi, Fujii Yukihiko
Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata 951-8585, Japan.
Childs Nerv Syst. 2007 May;23(5):577-80. doi: 10.1007/s00381-006-0241-1. Epub 2006 Oct 7.
Split cord malformation (SCM) associated with myeloschisis is a very rare form of spinal dysraphism. We encountered a case of SCM associated with myeloschisis showing split neural placodes (hemicords) in the upper lumbar region.
Radiological examinations, including prenatal MRI and postnatal CT scan, clearly demonstrated a bony spur between the two hemicords as well as myeloschisis, which facilitated a precise preoperative diagnosis of this complex anomaly. Resection of the spur, closure of the myeloschisis, and untethering of the thickened filum terminale were successfully accomplished in one stage. The presence of SCM associated with myeloschisis is consistent with the hypothesis of an ontogenic basis of neural development, and we emphasize the importance of early imaging including prenatal MRI for diagnosing this complex anomaly.
伴有脊髓裂的脊髓分裂畸形(SCM)是一种非常罕见的脊柱裂形式。我们遇到了一例伴有脊髓裂的SCM病例,其在上腰椎区域显示出分裂的神经板(半脊髓)。
包括产前MRI和产后CT扫描在内的影像学检查清楚地显示了两个半脊髓之间的骨棘以及脊髓裂,这有助于对这种复杂异常进行精确的术前诊断。一期成功完成了骨棘切除、脊髓裂闭合以及增厚终丝的松解。伴有脊髓裂的SCM的存在与神经发育的个体发生学基础假说一致,并且我们强调早期影像学检查(包括产前MRI)对于诊断这种复杂异常的重要性。