An unusual case of spinal dysraphism with four splits including three posterior spurs.

Abstract:

BACKGROUND:Composite-type split spinal cord malformation (SCM) is very rare and results from 2 separate foci of ectoendodermal adhesions and endomesenchymal tracts leading to the development of SCM with an intervening normal cord in the same patient. Posterior spurs are even rarer. We report a unique case of composite SCM, where the patient had 3 posterior bony spurs and 1 fibrous spur at different levels. To our knowledge, this is the first reported case of a patient having composite-type SCM with posterior spurs at 3 different levels. CLINICAL PRESENTATION:A 3-year-old girl presented to us with progressively worsening scoliosis. Neurological examination was unremarkable except for mild weakness in the left lower limb. Three-dimensional CT imaging demonstrated posterior bony spurs located at T(6), T(12) and L(3) levels. The patient underwent T(11)-L(5) laminoplasty and T(5)/T(6) laminectomy and excision of SCM type 1 with division of the thickened filum terminale. All the bony spurs arose from the inner surface of the lamina, where the base of the spur was located. CONCLUSIONS:The unique point of this case report is the rarity of such a presentation. Careful planning and knowledge of the occurrence of such conditions can make surgery in these children safe, and all the levels can be treated in a single setting.

journal_name

Pediatr Neurosurg

journal_title

Pediatric neurosurgery

authors

Ailawadhi P,Mahapatra AK

doi

10.1159/000336752

subject

Has Abstract

pub_date

2011-01-01 00:00:00

pages

372-5

issue

5

eissn

1016-2291

issn

1423-0305

pii

000336752

journal_volume

47

pub_type

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