Dias M S, Pang D
Department of Pediatric Neurosurgery, Children's Hospital of Buffalo, New York, USA.
Neurosurg Clin N Am. 1995 Apr;6(2):339-58.
Previous classifications of split cord malformations (SCM's), including such terms as diastematomyelia and diplomyelia, have done little to foster a true understanding of these disorders. The authors instead propose a unifying classification in which all SCM's share a common embryogenesis. SCM's are divided into two types, based upon the composition of the dural coverings and intervening mesenchymal tissue. Type I malformations are composed of two dural sacs and a bony or fibrocartilaginous spur; Type II malformations are composed of a single dural sac and intradural fibrous bands. In either case, the intervening mesenchymal elements contribute to progressive neurologic, urologic, and orthopedic deterioration from spinal cord tethering. The natural history of these lesions supports an early and aggressive operative approach to untether the spinal cord before clinical deterioration begins.
以往对脊髓纵裂畸形（SCM）的分类，包括诸如脊髓纵裂和双脊髓等术语，对真正理解这些疾病几乎没有帮助。相反，作者提出了一种统一的分类方法，其中所有的脊髓纵裂畸形都有共同的胚胎发生过程。根据硬脊膜覆盖物和中间间充质组织的组成，脊髓纵裂畸形分为两种类型。I型畸形由两个硬脊膜囊和一个骨或纤维软骨棘组成；II型畸形由单个硬脊膜囊和硬脊膜内纤维带组成。在任何一种情况下，中间的间充质成分都会导致脊髓栓系引起的进行性神经、泌尿和骨科功能恶化。这些病变的自然病程支持在临床恶化开始前尽早采取积极的手术方法松解脊髓。
