SPLIT SPINAL-CORD MALFORMATIONS IN CHILDREN

Object. The authors reviewed and analyzed information on 74 patients w ith split spinal cord malformations (SSCMs) treated between January 1, 1980 and December 31, 1996 at their institution with the aim of defin ing and classifying the malformations according to the method of Pang, et al. Methods. Computerized tomography myelography was superior to o ther radiological tools in defining the type of SSCM. There were 46 gi rls (62%) and 28 boys (38%) ranging in age from less than 1 day to 12 years (mean 33.08 months). The mean age (43.2 months) of the patients who exhibited neurological deficits and orthopedic deformities was sig nificantly older than those (8.2 months) without deficits (p = 0.003). Fifty-two patients had a single Type I and 18 patients a single Type II SSCM; four patients had composite SSCMs. Sixty-two patients had at least one associated spinal lesion that could lead to spinal cord teth ering. After surgery, the majority of the patients remained stable and clinical improvement was observed in 18 patients. Conclusions. The cl assification of SSCMs proposed by Pang, et al., will eliminate the cur rent chaos in terminology. In all SSCMs, either a rigid or a fibrous s eptum was found to transfix the spinal cord. There was at least one un related lesion that caused tethering of the spinal cord in 85% of the patients. The risk of neurological deficits resulting from SSCMs incre ases with the age of the patient; therefore, all patients should be su rgically treated when diagnosed, especially before the development of orthopedic and neurological manifestations.