Study Design: Case Series of 19 Patients Operated for Severe Scoliosis and Diastematomyelia

Abstract

Objective: Diastematomyelia is a rare congenital spine and spinal cord malformation in which the spinal cord is divided into two parts by the osseous or fibrous septum. The incidence of diastematomyelia in patients with the most severe forms of congenital scoliosis is much higher than its general incidence in the population. When performing surgeries to correct scoliotic deformities, the question arises regarding the choice of a strategy for managing the septum. An unambiguous answer to this question does not exist, since the disease is very rare and heterogeneous. The aim was to summarize the data on different surgical strategies for detecting diastematomyelia. Methods: Literature review and retrospective analysis of our own clinical data. Results: We present our own experience of treating 19 patients with diastematomyelia and severe congenital scoliosis. Posture disorder was corrected in all cases; the septum was removed in none of the cases. Significant correction was achieved for all patients, and no neurological complications were observed in the short- and long-term follow-up. Conclusions: Surgical nonremoval of the spur enables compensation to be achieved, without neurological complications either in the immediate postoperative period or in the long-term (more than 2 years) follow-up. Level of Evidence IV; Case seriesh.

Results of simultaneous and staged surgical techniques for the correction of congenital spine deformities associated with intracanal anomalies in children

“…Ряд авторов [13][14][15][16] вообще ставит под сомнение необходимость удаления интраканального компонента патологии и приводит обнадеживающие данные по коррекции таких деформаций. По их мнению, данная тактика не приводит к развитию неврологических осложнений, кото-…”

“…Их оппоненты склоняются к одноэтапной хирургии [6][7][8][9]. Ряд авторов [13][14][15][16] ставит под сомнение необходимость удаления интраканального компонента патологии перед оперативной коррекцией деформации позвоночника. При этом большинство работ представлено ретроспективным анализом серий случаев или малых когорт (уровень доказательности -4 по UK Oxford, версия 2009) без сравнения результатов по единым критериям оценки, что и явилось мотивацией для авторов к проведению Hirurgia Pozvonochnika (spine surgery) 2020;17(4): 6-15 ХИРУРГИЯ ПОЗВОНОЧНИКА 2020.…”