The Effect of Surgery for Split Spinal Cord Malformation on Neurologic and Urologic Function

Abstract

The split spinal cord malformation (SSCM) is an occult spinal dysraphism which causes tethering of the spinal cord. We performed a retrospective analysis of 15 patients who had split cord malformations (without associated open neural tube defect) who underwent both pre- and postoperative urodynamic studies (UDS) in order to determine if a significant percentage of these patients, even in the absence of overt urologic symptoms, had evidence of urologic dysfunction. Eleven patients presenting in early childhood and 4 patients presenting later in life are reviewed. Despite the lack of preoperative urologic symptoms in almost all patients, 73% of patients had voiding abnormalities on formal testing. UDS on these patients before and after surgery was a useful adjunct to perioperative management and decision making, helped define the success of surgery, and gave objective information for cases in which retethering was suspected.

Fetal diastematomyelia associated with vertebral malformation: ultrasound, MRI, and pathomorphological findings

“…In addition, a fibrous septum or split cord may be missed by US if an osseous or nonossified fibrous septum is present within a single dural tube (type II). Differentiation of the type has surgical importance because type I split cords are technically more difficult to correct and are associated with more surgical morbidity than type II [5].…”

Prevalence of Primary Tethered Cord Syndrome Associated with Occult Spinal Dysraphism in Primary School Children in Turkey

“…Partial traction on the spinal cord can lead to decreased local blood fl ow and impaired oxidative metabolism, resulting in neuronal dysfunction which manifests itself in neurologic, musculoskeletal and urologic abnormalities [2,14] . As the operative goal of untethering is to halt the progression of the neurological deficits, to stabilize and/or to reverse symptoms, early detection is strongly recommended [1,[15][16][17] .…”

“…Early surgical intervention may halt the progression of the neurologic defi cits and stabilize or reverse symptoms. Copyright © 2006 S. Karger AG, Basel Primary tethered cord syndrome (PTCS) refers to a group of neural tube defects that are not externally obvious, and, if detected at an early age, surgical intervention may prevent the signifi cant irreversible neurologic deficits [1] . Abnormal fi xation of the spinal cord leads to its stretching, resulting in a compromise of its blood supply and subsequent ischemia of neural tissue [2,3] .…”

First report of overactive detrusor in association with hypospadias detected by urodynamic screening

“…In children with myelomeningocele, the overall incidence in the newborn period is approximately 57% [Bauer, 1991]. The incidences of neurogenic overactive detrusor in children with lipomeningocele and split-cord syndromes are 15 and 55%, respectively [Atala et al, 1992;Proctor et al, 2000]. Of children with vesicoureteral re£ux, almost 33% are thought to have overactive detrusor [Van Gool et al, 1992].…”