Split spinal cord malformation: report of 5 cases in a single Chinese center and review of the literature.

BACKGROUND

Split spinal cord malformation (SSCM) is rare in scoliosis. This study evaluated the safety and effectiveness of one-stage surgical treatment of congenital scoliosis (CS) in patients with SSCM in a single Chinese center.

METHOD

A retrospective study of 5 cases who underwent surgery for CS with SSCM (2 type I and 3 type II) from March 2004 to March 2012. Patients included 4 females and 1 male with a mean age of 13.8 years. All patients underwent one-stage posterior fusion surgery with resection of a bony spur firstly in SSCM type I, but we did nothing to the SSCM in type II. Clinical symptoms and radiological changes were evaluated preoperatively and for at least 2 years postoperatively.

RESULTS

Preoperatively, 5 patients had variant neurological and other symptoms. They had a mean preoperative Cobb angle of 63 ± 20° and T5-T12 kyphosis of 30 ± 21°. The mean postoperative Cobb angle was 30.2 ± 19.8° with a correction rate of 57.2 ± 17.0%. At the 3-month follow-up the Cobb angle loss was 3.0 ± 6.8°, and at the 2-year follow-up the Cobb angle loss was 6.5 ± 9.7°. Hyperkyphosis was significantly corrected after surgery but correction loss was indicated at the 2-year follow-up (p < 0.01). There were no neurological deficit complications or deteriorated neurological signs postoperatively or at follow-up.

CONCLUSIONS

One-stage surgical treatment of CS with SSCM could be safe and effective, but we need further multicenter studies with larger samples. Intraspinal intervention of bone spur was recommended in SSCM type I before deformity correction, while in SSCM type II it was needless.