Neurol India. 2001 Jun;49(2):128-33.

Split cord malformation (scm) in paediatric patients: outcome of 19 cases.

Kumar R, Bansal KK, Chhabra DK.

Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical
Sciences, Lucknow, 226014, India.

There had been considerable debate regarding the surgical outcome of
neuro-orthopaedic syndromes (NOS) and neurological syndromes in cases of split
cord malformation (SCM). On retrospective analysis of 19 cases of SCM, thirteen
were grouped under (Pang) type I and 6 in type II. Their age ranged from 1 month
to 9 years (mean 3.5 years). 14 of these were male children. The NOS without
neurological signs was detected in 6 cases where as pure neurological signs
without NOS were seen in 8 patients. However, the rest 5 had mixed picture of NOS
and neurological dysfunction. Nine of 19 cases presented with cutaneous stigmata,
mainly in the form of hairy patch. 18 cases had other associated craniospinal
anomalies i.e. hydrocephalus, meningomyelocoele, syrinx, dermoid, teratoma etc.
Detethering of cord was done in all cases by removal of fibrous/bony septum.
Associated anomalies were also treated accordingly. Follow up of these cases
ranged from 6 months to 6 years. Six cases of NOS group neither showed
deterioration nor improvement, and remained static on follow up. However, four of
8 children with neurological signs showed improvement in their motor weakness,
and 1 in saddle hypoaesthesia as well as bladder/bowel function. In 5 cases of
mixed group, two had improvement in their weakness and one in hypoaesthesia, but
no change was noticed in NOS of this group as well. Hence surgery seemed to be
effective, particularly in patients with neurological dysfunction.