Is it Necessary to Operate All Split Cord Malformations Before Corrective Surgery for Patients With Congenital Spinal Deformities?

Retrospective case series. To evaluate the necessity of neurosurgical interventions for split cord malformations (SCMs) before correction and instrumentation for patients with congenital spinal deformity(CSD)s. SCMs are commonly associated with CSD. As pathology of SCMs understood well, the common b...

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Veröffentlicht in:Spine (Philadelphia, Pa. 1976) Pa. 1976), 2009-10, Vol.34 (22), p.2413-2418
Hauptverfasser: AYVAZ, Mehmet, AKALAN, Nejat, YAZICI, Muharrem, ALANAY, Ahmet, EMRE ACAROGLU, R
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container_issue 22
container_start_page 2413
container_title Spine (Philadelphia, Pa. 1976)
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creator AYVAZ, Mehmet
AKALAN, Nejat
YAZICI, Muharrem
ALANAY, Ahmet
EMRE ACAROGLU, R
description Retrospective case series. To evaluate the necessity of neurosurgical interventions for split cord malformations (SCMs) before correction and instrumentation for patients with congenital spinal deformity(CSD)s. SCMs are commonly associated with CSD. As pathology of SCMs understood well, the common belief of all SCM must be operated before any orthopedic intervention is needed to be revised. Sixty-one consecutive patients with CSD and spinal dysraphism treated by correction and posterior instrumentation between 1994 and 2005 were retrospectively evaluated. Inclusion criteria were patients with CSD and SCM, who were treated with long segment instrumentation (more than 6 functional units) with at least 2 years of follow-up. Thirty-two patients (8 male and 24 female) with an age average of 11 years +8 months (4-18 years) fulfilled the criteria. While all patients with Type I SCM were managed with neurosurgical intervention (spur excision and dural reconstruction) before corrective surgery, Type II SCM cases were treated by instrumented fusion without neurologic intervention. There were 18 patients with Type I and 14 patients with Type II SCM. The average follow-up was 52 (24-144) months. The correction rate of deformity was 44% in type I and 47% in Type II SCM. Two patients with Type II SCM had transient neurologic deterioration while there were no neurologic events in patients with Type II SCM. Due to high incidence of SCMs, all patients with CSDs must be evaluated with MRI, before surgery. Neurosurgical interventions are recommended even for neurologically asymptomatic Type I SCM before spinal deformity surgery; however, patients with Type II SCM can be treated safely without a need of neurosurgical intervention.
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To evaluate the necessity of neurosurgical interventions for split cord malformations (SCMs) before correction and instrumentation for patients with congenital spinal deformity(CSD)s. SCMs are commonly associated with CSD. As pathology of SCMs understood well, the common belief of all SCM must be operated before any orthopedic intervention is needed to be revised. Sixty-one consecutive patients with CSD and spinal dysraphism treated by correction and posterior instrumentation between 1994 and 2005 were retrospectively evaluated. Inclusion criteria were patients with CSD and SCM, who were treated with long segment instrumentation (more than 6 functional units) with at least 2 years of follow-up. Thirty-two patients (8 male and 24 female) with an age average of 11 years +8 months (4-18 years) fulfilled the criteria. While all patients with Type I SCM were managed with neurosurgical intervention (spur excision and dural reconstruction) before corrective surgery, Type II SCM cases were treated by instrumented fusion without neurologic intervention. There were 18 patients with Type I and 14 patients with Type II SCM. The average follow-up was 52 (24-144) months. The correction rate of deformity was 44% in type I and 47% in Type II SCM. Two patients with Type II SCM had transient neurologic deterioration while there were no neurologic events in patients with Type II SCM. Due to high incidence of SCMs, all patients with CSDs must be evaluated with MRI, before surgery. Neurosurgical interventions are recommended even for neurologically asymptomatic Type I SCM before spinal deformity surgery; however, patients with Type II SCM can be treated safely without a need of neurosurgical intervention.</description><identifier>ISSN: 0362-2436</identifier><identifier>EISSN: 1528-1159</identifier><identifier>DOI: 10.1097/BRS.0b013e3181b9c61b</identifier><identifier>PMID: 19829255</identifier><identifier>CODEN: SPINDD</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams &amp; Wilkins</publisher><subject>Abnormalities, Multiple - surgery ; Adolescent ; Biological and medical sciences ; Cerebrospinal fluid. Meninges. Spinal cord ; Child ; Child, Preschool ; Disability Evaluation ; Female ; Humans ; Incidence ; Injuries of the nervous system and the skull. Diseases due to physical agents ; Laminectomy - methods ; Laminectomy - standards ; Male ; Medical sciences ; Nervous system (semeiology, syndromes) ; Nervous System Malformations - complications ; Nervous System Malformations - pathology ; Nervous System Malformations - surgery ; Neurology ; Neurosurgical Procedures - methods ; Neurosurgical Procedures - standards ; Outcome Assessment (Health Care) ; Reconstructive Surgical Procedures - methods ; Reconstructive Surgical Procedures - standards ; Retrospective Studies ; Severity of Illness Index ; Spinal Cord - abnormalities ; Spinal Cord - surgery ; Spinal Dysraphism - complications ; Spinal Dysraphism - pathology ; Spinal Dysraphism - surgery ; Spinal Fusion - methods ; Spinal Fusion - standards ; Syndrome ; Traumas. 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To evaluate the necessity of neurosurgical interventions for split cord malformations (SCMs) before correction and instrumentation for patients with congenital spinal deformity(CSD)s. SCMs are commonly associated with CSD. As pathology of SCMs understood well, the common belief of all SCM must be operated before any orthopedic intervention is needed to be revised. Sixty-one consecutive patients with CSD and spinal dysraphism treated by correction and posterior instrumentation between 1994 and 2005 were retrospectively evaluated. Inclusion criteria were patients with CSD and SCM, who were treated with long segment instrumentation (more than 6 functional units) with at least 2 years of follow-up. Thirty-two patients (8 male and 24 female) with an age average of 11 years +8 months (4-18 years) fulfilled the criteria. While all patients with Type I SCM were managed with neurosurgical intervention (spur excision and dural reconstruction) before corrective surgery, Type II SCM cases were treated by instrumented fusion without neurologic intervention. There were 18 patients with Type I and 14 patients with Type II SCM. The average follow-up was 52 (24-144) months. The correction rate of deformity was 44% in type I and 47% in Type II SCM. Two patients with Type II SCM had transient neurologic deterioration while there were no neurologic events in patients with Type II SCM. Due to high incidence of SCMs, all patients with CSDs must be evaluated with MRI, before surgery. Neurosurgical interventions are recommended even for neurologically asymptomatic Type I SCM before spinal deformity surgery; however, patients with Type II SCM can be treated safely without a need of neurosurgical intervention.</description><subject>Abnormalities, Multiple - surgery</subject><subject>Adolescent</subject><subject>Biological and medical sciences</subject><subject>Cerebrospinal fluid. Meninges. Spinal cord</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Disability Evaluation</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Injuries of the nervous system and the skull. Diseases due to physical agents</subject><subject>Laminectomy - methods</subject><subject>Laminectomy - standards</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Nervous System Malformations - complications</subject><subject>Nervous System Malformations - pathology</subject><subject>Nervous System Malformations - surgery</subject><subject>Neurology</subject><subject>Neurosurgical Procedures - methods</subject><subject>Neurosurgical Procedures - standards</subject><subject>Outcome Assessment (Health Care)</subject><subject>Reconstructive Surgical Procedures - methods</subject><subject>Reconstructive Surgical Procedures - standards</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><subject>Spinal Cord - abnormalities</subject><subject>Spinal Cord - surgery</subject><subject>Spinal Dysraphism - complications</subject><subject>Spinal Dysraphism - pathology</subject><subject>Spinal Dysraphism - surgery</subject><subject>Spinal Fusion - methods</subject><subject>Spinal Fusion - standards</subject><subject>Syndrome</subject><subject>Traumas. 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Diseases due to physical agents</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>AYVAZ, Mehmet</creatorcontrib><creatorcontrib>AKALAN, Nejat</creatorcontrib><creatorcontrib>YAZICI, Muharrem</creatorcontrib><creatorcontrib>ALANAY, Ahmet</creatorcontrib><creatorcontrib>EMRE ACAROGLU, R</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Spine (Philadelphia, Pa. 1976)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>AYVAZ, Mehmet</au><au>AKALAN, Nejat</au><au>YAZICI, Muharrem</au><au>ALANAY, Ahmet</au><au>EMRE ACAROGLU, R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is it Necessary to Operate All Split Cord Malformations Before Corrective Surgery for Patients With Congenital Spinal Deformities?</atitle><jtitle>Spine (Philadelphia, Pa. 1976)</jtitle><addtitle>Spine (Phila Pa 1976)</addtitle><date>2009-10-15</date><risdate>2009</risdate><volume>34</volume><issue>22</issue><spage>2413</spage><epage>2418</epage><pages>2413-2418</pages><issn>0362-2436</issn><eissn>1528-1159</eissn><coden>SPINDD</coden><abstract>Retrospective case series. To evaluate the necessity of neurosurgical interventions for split cord malformations (SCMs) before correction and instrumentation for patients with congenital spinal deformity(CSD)s. SCMs are commonly associated with CSD. As pathology of SCMs understood well, the common belief of all SCM must be operated before any orthopedic intervention is needed to be revised. Sixty-one consecutive patients with CSD and spinal dysraphism treated by correction and posterior instrumentation between 1994 and 2005 were retrospectively evaluated. Inclusion criteria were patients with CSD and SCM, who were treated with long segment instrumentation (more than 6 functional units) with at least 2 years of follow-up. Thirty-two patients (8 male and 24 female) with an age average of 11 years +8 months (4-18 years) fulfilled the criteria. While all patients with Type I SCM were managed with neurosurgical intervention (spur excision and dural reconstruction) before corrective surgery, Type II SCM cases were treated by instrumented fusion without neurologic intervention. There were 18 patients with Type I and 14 patients with Type II SCM. The average follow-up was 52 (24-144) months. The correction rate of deformity was 44% in type I and 47% in Type II SCM. Two patients with Type II SCM had transient neurologic deterioration while there were no neurologic events in patients with Type II SCM. Due to high incidence of SCMs, all patients with CSDs must be evaluated with MRI, before surgery. Neurosurgical interventions are recommended even for neurologically asymptomatic Type I SCM before spinal deformity surgery; however, patients with Type II SCM can be treated safely without a need of neurosurgical intervention.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams &amp; Wilkins</pub><pmid>19829255</pmid><doi>10.1097/BRS.0b013e3181b9c61b</doi><tpages>6</tpages></addata></record>
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subjects Abnormalities, Multiple - surgery
Adolescent
Biological and medical sciences
Cerebrospinal fluid. Meninges. Spinal cord
Child
Child, Preschool
Disability Evaluation
Female
Humans
Incidence
Injuries of the nervous system and the skull. Diseases due to physical agents
Laminectomy - methods
Laminectomy - standards
Male
Medical sciences
Nervous system (semeiology, syndromes)
Nervous System Malformations - complications
Nervous System Malformations - pathology
Nervous System Malformations - surgery
Neurology
Neurosurgical Procedures - methods
Neurosurgical Procedures - standards
Outcome Assessment (Health Care)
Reconstructive Surgical Procedures - methods
Reconstructive Surgical Procedures - standards
Retrospective Studies
Severity of Illness Index
Spinal Cord - abnormalities
Spinal Cord - surgery
Spinal Dysraphism - complications
Spinal Dysraphism - pathology
Spinal Dysraphism - surgery
Spinal Fusion - methods
Spinal Fusion - standards
Syndrome
Traumas. Diseases due to physical agents
title Is it Necessary to Operate All Split Cord Malformations Before Corrective Surgery for Patients With Congenital Spinal Deformities?
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