Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
World Neurosurg. 2024 Aug;188:e163-e167. doi: 10.1016/j.wneu.2024.05.074. Epub 2024 May 17.
Split cord malformation (SCM), associated with neurologic deficits, necessitates surgical intervention for spinal cord detethering. Limited evidence exists regarding its impact on children's quality of life. Our study aims to evaluate the postoperative quality of life in children treated for SCM.
This retrospective cohort study examined records of patients with SCM operated on between July 1, 2012, and July 31, 2022, at a single center. Data, including Health Utility Index-3 (HUI-3) scores provided by guardians, was collected to assess quality of life. Clinical and neurologic outcomes were also analyzed.
Twenty-five patients, predominantly female (68%), with a median age of 7 years, were included. Most presented with normal motor function (76%). The most common anatomic level of SCM was lumbar (12; 48%) followed by lumbosacral (5; 20%). A bony spur from the lamina was the most common cause of splitting the cord (64%). Over a median follow-up of 3.3 years, 64% of patients showed neurologic stability, 16% showed neurologic improvement, and 4% experienced deterioration. The mean HUI-3 score for 21 children was 0.93 ± 0.24.
Surgical management of SCM showed favorable neurologic outcomes and a positive long-term quality of life, as shown by HUI-3 scores. Our findings emphasize the efficacy of surgical intervention in improving the lives of children with this condition.
脊髓分裂畸形(SCM)伴发神经功能缺损,需要进行脊髓松解手术。目前关于其对儿童生活质量影响的证据有限。本研究旨在评估接受 SCM 治疗的儿童术后生活质量。
这是一项回顾性队列研究,对 2012 年 7 月 1 日至 2022 年 7 月 31 日在单中心接受手术治疗的 SCM 患者的病历进行了检查。收集了包括监护人提供的健康效用指数-3(HUI-3)评分在内的数据,以评估生活质量。还分析了临床和神经功能预后。
共纳入 25 例患者,女性居多(68%),中位年龄为 7 岁。大多数患者运动功能正常(76%)。SCM 最常见的解剖部位为腰椎(12 例,48%),其次为腰骶部(5 例,20%)。最常见的脊髓分裂原因是椎板骨棘(64%)。在中位随访 3.3 年期间,64%的患者神经功能稳定,16%的患者神经功能改善,4%的患者神经功能恶化。21 名儿童的平均 HUI-3 评分为 0.93±0.24。
SCM 的手术治疗显示出良好的神经功能预后和长期的积极生活质量,这可以从 HUI-3 评分中得到体现。我们的研究结果强调了手术干预在改善此类患儿生活质量方面的有效性。