Profile of paediatric patients with split cord malformation

AimTo present a case series of pediatric patients with split cord malformations , and to discuss the clinical presentations, radiological findings and the management.MethodsAll patients with age less than 18 years with clinical or radiological features of split cord malformations who had been admitted during march 2008 to march 2011 at madras institute of neurology were included in this study. 27 patients among the age group ranging from 1yr 3months to 16 yrs age were studied. 12 males and 15 females, with 25 patients having type I(pang classification) and 2 having type 2 split cord malformations. 16 patients had cutaneous stigmata. 11patients had orthopaedic problems. 5 patients had both. Back pain and leg pains were seen in 12 patients.15patients had motor involvement, 12 had sensory involvement and 10 had bladder involvement. 4 patients were without any neurological deficit. 7 patient had split cord at the lumbar level and 7 patient had in the thoracic level, 13 had dorsolumbar region. MRI scan revealed associated dermal sinus tract, epidermoids , lipoma and thickenened filum terminale . Detethering procedure had been done in all patients depending upon the type of tethering. Associated anomalies were also addressed.Follow up neurological examination was done at 3 and 6 months interval.Results18 patients experienced better or stable neurological status, 7 patient did not show any improvement in bladder function, 1 patient had worsening in neurological status 1 patient developed hydrocephalus for which ventriculoperitoneal shunt was done