ABSTRACT

Although surgical treatment of split cord malformations (SCM) is well known, the surgical problems and their solutions are not sufficiently investigated. The aims of this study are to point out the details of surgical treatment of SCM, to define possible peroperative problems and to suggest solutions.

Thirty-six cases with the diagnosis of SCM had been surgically treated in our department between 1999 and 2011. Twenty-three of them were Type I, 11 were Type II and 2 were composite type. Removal of bony septum, combination of two hemicords in one dura and release of the spinal cord were performed for type I. Removal of fibrous band and release of the spinal cord were performed for type II. For composite type, the hemicords were unified in the first step and then the spinal cord was released. Dorsal paramedian roots, fibrous bands, nutritional artery within the septum, neural connections between the hemicords and tight filum terminale were the risky structures during the surgery.

As a conclusion; surgery of the SCM is unique like no other spinal surgery and has its own technique. One should be aware of the pitfalls during the surgery and appropriate precautions should be taken.

Keywords: Split cord malformation, surgical technique, pitfall