Bothara Shivani S, Parihar Pratap
Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND.
Cureus. 2024 Feb 28;16(2):e55197. doi: 10.7759/cureus.55197. eCollection 2024 Feb.
This case report presents the clinical and radiological findings of a seven-year-old female with type 2 diastematomyelia and spina bifida, emphasizing the complexity of congenital spinal anomalies in pediatric patients. The patient presented with a two-month history of lower back pain, prompting diagnostic investigations. Radiographic examination revealed spina bifida at the L3-L5 levels, subsequently confirmed by magnetic resonance imaging (MRI), which disclosed bifid spinous processes, an absent posterior arch, and a split spinal cord terminating at the L3-L4 disc levels. The Vancouver classification system facilitated a standardized characterization of congenital spinal anomalies. The multidisciplinary approach involving orthopedic and neurosurgical specialists led to a conclusive diagnosis of type 2 diastematomyelia with simple spinal dysraphism. Surgical intervention, encompassing laminectomy and correction of the split spinal cord, was successfully performed, resulting in the stabilization of the patient. This case underscores the importance of early diagnosis, advanced imaging modalities, and collaborative management in addressing rare congenital spinal anomalies. The discussion delves into the clinical implications, diagnostic challenges, and the pivotal role of surgical intervention. Insights from this case contribute to the existing literature, guiding healthcare professionals in understanding and managing similar cases with potential implications for future research and treatment strategies.
本病例报告展示了一名患有2型脊髓纵裂和脊柱裂的7岁女性的临床和影像学检查结果,强调了儿科患者先天性脊柱异常的复杂性。该患者有两个月的下背部疼痛病史,促使进行诊断性检查。X线检查显示L3 - L5水平存在脊柱裂,随后磁共振成像(MRI)证实了这一点,MRI显示棘突分叉、后弓缺如以及脊髓分裂止于L3 - L4椎间盘水平。温哥华分类系统有助于对先天性脊柱异常进行标准化特征描述。由骨科和神经外科专家组成的多学科方法得出了2型脊髓纵裂合并单纯性脊柱闭合不全的明确诊断。成功实施了包括椎板切除术和脊髓分裂矫正术在内的手术干预,使患者病情稳定。本病例强调了早期诊断、先进影像学检查方法以及协作管理在处理罕见先天性脊柱异常方面的重要性。讨论深入探讨了临床意义、诊断挑战以及手术干预的关键作用。该病例的见解丰富了现有文献,指导医疗保健专业人员理解和处理类似病例,对未来研究和治疗策略具有潜在意义。