[One stage surgical treatment of congenital scoliosis associated with split cord malformation].

OBJECTIVE

To investigate the clinical results of one stage surgical treatment in congenital scoliosis (CS) patients associated with split cord malformation (SCM).

METHODS

Between January 2007 and December 2010, 50 patients underwent one stage surgical treatment for CS associated with SCM. Among of them, 38 patients (13 male and 25 female) with an average age of (15 ± 6) years, who were followed up in the clinic at least 2 years longer, were include in the study. There were 12 patients with Type I SCM and 26 patients with Type II SCM Pre-operative, post-operative and the follow-up imaging data were collected and compared by paired t-test, while imaging data between Type I SCM group and Type II SCM group were compared by group t-test. Bony spur was first resected to the Type I SCM while nothing was done to the Type II SCM. Then, all patients were followed by posterior corrective procedure in one stage. Meanwhile, duraplasty were only applied in 5 patients whose dural cleft were more than 1 cm longer.

RESULTS

The average follow-up was 41 ± 13 months (range, 26-68 months). The average operation time was 491 ± 152 minutes (range, 105-780 minutes) and the average blood loss was (1 933 ± 1 516) ml (range, 1 000-8 000 ml). The mean major coronal curve was corrected from 70° ± 26° preoperatively to 312° ± 16° postoperatively with a correction rate of 57% ± 18%, and 33° ± 17° at the final follow-up with a correction rate of 54% ± 20%. The mean major sagittal curve was corrected from 43° ± 31° to 26° ± 16°, and 27° ± 15° at the final follow-up. The postoperative complication occurred in 2 patients (5.3%) with Type I SCM, including neurological deterioration in 1 patient (2.6%) and cerebrospinal fluid leakage in 1 patient (2.6%). There were no paralysis and other serious complications. The patients who suffered from neurological deterioration recovered to the preoperative neurological status at 30 months postoperatively and no further improvement at the final follow-up.

CONCLUSION

It is safe and efficient to treat the CS associated with SCM by one stage surgery without increasing the risk of neurological complications postoperatively.