A case of split cord malformation with triple bony spur
Split cord malformation-I (SCM-I) is characterized by the presence of double dural sacs, with rigid extradural bony/cartilaginous spur leading to a symmetrical or asymmetrical division of the cord. In split cord malformation-II (SCM-II), there is a single dural sac with a nonrigid fibrous spur and symmetrical division of the cord.

SCM-II are slightly more common than SCM-I, constituting around 50 to 60% of SCMs. Published in the Indian Journal of Neurosurgery, the authors report a unique case of SCM with triple bony spurs lying both intra- and extradurally in a single dural sleeve. No other case of SCM with triple bony spurs in single dural sleeve has been reported anywhere in the world literature.

This was a case of a 3-year-old male child, who presented with complaints of congenital deformity of spine and progressively worsening scoliosis of the spine along with abnormal hairy patch over midline in the back. Clinically the patient had scoliosis to the right along with hypertrichosis. He, however, had no neurologic deficit and had no lower limb weakness or sphincter disturbance.

Computed tomographic (CT) of the spine showed bony spurs at the level of D6, D10, and D12 vertebrae. The patient was taken up for surgery and exploration. The site of split was explored first after adequately removing the spur and other tethering elements at the site. Filum de-tethering was performed in a single stage. Perioperatively the findings of MRI scan were confirmed in the form of there being a single dural sleeve.

The bony spurs were intradural for the maximum extent; however, because the bony spurs were attached to both the posterior aspect of the body of vertebrae and to the lamina after piercing out through the dural sleeve both ventrally and dorsally, they were technically deemed to be both intra- and extradural. The postoperative period remained uneventful, and at 4 months after surgery, he had no deficits.

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