DISCUSSION. Background: Split cord malformation (SCM) remains an important cause of tethered cord syndrome. The female predominance was slightly more remarkable in type I SCMs than in type II SCMs. MahapatraAn unusual case of 4 level spinal dysraphism: multiple composite type 1 and type 2 split cord malformation, dorsal myelocystocele and hydrocephalous. 84: 246-8. The complete or partial division of the spinal cord is due to the presence of a septum in the central part of the spinal canal. One or more skin stigmata were present in 60% cases, hypertrichosis being the most common. Neurosurgery. DIASTEMATOMYELIA or split cord malformation is a rare phenomenon that may be discovered on magnetic resonance imaging of the spine. Type 1.5 split cord malformation? Report of two cases with literature review. A. Agarwal, A. Raheja, S.A. Borkar, A.K. This classification highlights the importance of pure or combined occurrence. L5 and S1), split cord malformation type I which separated two hemi-cords, tethered cord and syringomyelia. A Type I SCM consists of two hemicords, each contained within its own dural tube and separated by a dura-sheathed rigid osseocartilaginous median septum. The term is from the Greek "diastema" (cleft) and "myelos" (marrow or medulla). Usually, the cord is split by some type of mesenchymal derivative such as bone or cartilage. To add on Pangs classification, we proposed a sub classification into type A and B on basis of whether Split cord malformation (SCM) is associated with meningomyelocoele or not. Neurosurgery. In type I, the two hemicords are typically separated by a fibrous, cartilaginous, or osseous septum and reside in two separate dural tubes (Figure 7). Background Split cord malformation (SCM) remains an important cause of tethered cord syndrome. Preoperatively the patient had paraparesis and discretely moved his left foot. Five out of nine patients that had preoperative bladder dysfunction were improved. A Type II SCM consists of two hemicords housed in a single dural tube separated by a nonrigid, fibrous median septum. The management can be further complicated by the other associated dysraphic states in the same patient. We report the rare finding of a split cord malformation in a young girl. Diastematomyelia: a type 1 split spinal cord malformation. Sometimes there is only one protective membrane or sleeve (the dura) around both parts of the spinal cord. In the SSCM Type II, both parts of the spinal cord are surrounded by a common dura tube. [Google Scholar] 34. 13. Warder DE, Oakes WJ. A. Khandelwal, V. Tandon, A.K. 2018; 52:119–21. 14. 160: 1180-6 . The differential diagnosis includes dimyelia (complete spinal cord duplication) and diplomyelia (the presence of an accessory spinal cord). In previous patient, authors reported a long-segment type 1 split cord malformation, with two-level split cord malformation and a single dural sac and the spur was at the lower end of split. Much confusion still exists concerning the pathological definitions and clinical significance of double spinal cord malformations. One hundred thirty-two patients had type I SCM and 71 had type II SCM. There was a bony spur arising from the D 11 body level without a separate dural covering but with 2 cords. Split cord malformation (SCM) is a rare congenital anomaly. Frequently with overlying cutaneous and/or subcutaneous abnormalities. Figure A is an axial T2-weighted image at the T12 level demonstrating diastematomyelia with two hemicords sharing a single … Surgical management of adult Type 1 split cord malformation. View Record in Scopus Google Scholar. People with type 1 may not have any symptoms or may develop symptoms when they are teenagers or adults. Compared with Type II SCM, patients with Type I SCM presented with higher incidence of kyphotic deformity, more extensive and complicated vertebral anomalies, and more complex rib anomalies. This septum can be formed out of bone tissue or it can be cartilaginous or fibrous. Introduction. Lipomyelomeningocele and lipomeningocele. Type 1—which may not cause symptoms—is the most common form of CM. Wolf AL, Tubman DE, Seljeskog EL. The split lengths of the 19 Type I lesions (including the one case of double bone spurs and tripartite cord, in which the two split lengths were identical) varied between 1 and 7 vertebral levels, with a mean of 2.97. The patient was admitted with a hypertrichosis and hyperpigmented patch. A personal series of 131 patients with split cord malformation (SCM) operated on is presented. SCM type 1, wherein a bony spur separates the two dural sacs, represents a challenging condition to treat. Whereas, in Type II split cord malformations both the hemicords lie withina single, non-duplicated, dural tube[2]. Background Split cord malformations (SCMs) are uncommon congenital anomalies. Split cord malformation is well documented and reported in various case series and reports in the literature. 2004. The mean age of the patients was 7.4 years and the female to male ratio was 1.3:1. It is the most common type. Type 1 occurs when the lower part of the cerebellum extends into the spinal canal. Age, gender, symptoms and signs, radiological and operative findings, complications, associated anomalies, outcome, and pathological specimens were analyzed. Chiari malformation type 1 is a structural abnormality of the cerebellum, the part of the brain that controls balance, and the skull. 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