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Split Spinal Cord Malformation (Diastematomyelia) – Diagnosis & Treatment by Dr. Vikas Kathuria

  • By : Admin
  • Date : 04 Jun 2025

Surgical intervention becomes necessary in cases of progressive neurological symptoms, tethered cord syndrome, or structural abnormalities. When these conditions are present, surgery can help alleviate symptoms and prevent further complications. Common surgical procedures include:Split Spinal Cord Malformation (SSCM), also known as diastematomyelia, is a rare congenital condition in which the spinal cord splits into two hemicords, each with its own protective covering. This complex spinal anomaly can result in neurological, orthopedic, and urological complications, requiring timely diagnosis and individualized treatment.

At the clinic of Dr. Vikas Kathuria, an experienced neurosurgeon and spine specialist in Gurgaon, patients with SSCM receive comprehensive care through advanced diagnostics, conservative management, and surgical intervention when needed.

What is Split Spinal Cord Malformation?

Split Spinal Cord Malformation occurs during embryonic development when the neural tube fails to close properly, leading to a longitudinal split of the spinal cord. The result is two spinal cord segments—either within a single dural sac (Type II) or separate sacs divided by a bony or fibrous spur (Type I).

This condition is often associated with other spinal abnormalities such as scoliosis, tethered cord syndrome, dermoid cysts, or lipomas, making it essential to have an expert evaluate and treat it early.

Causes of SSCM

The exact cause of SSCM lies in abnormal neural tube development in early gestation. Key contributing factors may include:

  • Genetic mutations or predispositions

  • Folic acid deficiency during pregnancy

  • Environmental exposures affecting fetal development

Common Symptoms of SSCM

Symptoms may vary depending on the extent and type of malformation. In many cases, the condition may not be diagnosed until symptoms emerge. These may include:

  • Persistent back pain

  • Muscle weakness or numbness in lower limbs

  • Scoliosis or spinal deformities

  • Difficulty walking or clumsiness

  • Bladder or bowel incontinence

  • Visible signs on the skin like dimples, tufts of hair, or fatty masses on the back

Diagnostic Approach by Dr. Vikas Kathuria

Dr. Vikas Kathuria uses a comprehensive and patient-centric diagnostic approach, including:

  • Neurological Examination: To identify sensory and motor deficits.

  • MRI Scan: The gold standard for visualizing spinal cord splits, tethering, and associated lesions like Chiari malformations or syringomyelia.

  • CT Myelography/3D CT: Helpful in evaluating bony abnormalities like vertebral spurs and classifying SSCM into Type I or II.

  • Urodynamic Testing: To assess bladder function in patients with incontinence or recurrent urinary tract infections.

  • EMG and Nerve Conduction Studies: For evaluating nerve involvement.

  • Prenatal Ultrasound (if applicable): For early fetal diagnosis.

Treatment Options Available at Dr. Vikas Kathuria’s Clinic

1. Conservative Management

For patients with mild symptoms or stable conditions:

  • Physical therapy

  • Pain management

  • Bracing for spinal deformities

  • Periodic monitoring with MRI and neurological assessments

2. Surgical Management

Surgical intervention becomes necessary in cases of progressive neurological symptoms, tethered cord syndrome, or structural abnormalities. When these conditions are present, surgery can help alleviate symptoms and prevent further complications. Common surgical procedures include:

  • Detethering Surgery: To release abnormal attachments and reduce spinal cord tension.

  • Spinal Fusion & Instrumentation: For patients with scoliosis or instability.

  • Resection of Bony/Fibrous Spurs: Especially in Type I SSCM.

  • Excision of Associated Lesions: Such as lipomas or dermoids, if present.

Dr. Vikas Kathuria emphasizes early intervention to prevent irreversible damage. He uses advanced microsurgical and neuro-monitoring techniques to ensure patient safety and better outcomes.

Postoperative Recovery

Recovery time varies by patient but typically includes:

  • A hospital stay for a few days post-surgery

  • Pain management and early mobilization

  • Customized physical rehabilitation

  • Follow-up imaging and urodynamic assessments

Patients are supported with individualized care plans for long-term neurological and orthopedic health.

FAQs on Split Spinal Cord Malformation

Q1: Is split spinal cord malformation life-threatening?
 No, SSCM is not typically life-threatening, but it can lead to severe neurological deficits if left untreated. Early intervention helps manage symptoms and prevent deterioration.

Q2: Can SSCM be diagnosed before birth?
 Yes. In some cases, prenatal ultrasounds in the second or third trimester may detect SSCM, especially when other anomalies are present.

Q3: What is the difference between Type I and Type II SSCM?
 Type I involves two hemicords in separate dural sacs, usually divided by a bony or fibrous spur. Type II involves two hemicords within a single dural sac, with no rigid divider.

Q4: What is the role of folic acid in prevention?
 Folic acid supplementation before and during early pregnancy reduces the risk of neural tube defects, including conditions like SSCM.

Q5: Can children with SSCM live a normal life?
 Yes, especially with early diagnosis and proper management. Many children achieve good functional outcomes post-treatment.

Q6: Is surgery always required for SSCM?
 Not always. Mild cases without symptoms may only need monitoring. Surgery is typically recommended when there are progressive symptoms or associated complications.

 

Conclusion

Split Spinal Cord Malformation is a rare yet serious congenital condition that requires timely diagnosis and personalized care. While it may present in infancy, childhood, or even adulthood, the key to successful outcomes lies in early intervention and expert management. With advancements in imaging and surgical techniques, patients affected by SSCM can lead healthier, more functional lives.

Dr. Vikas Kathuria, with his vast experience and commitment to patient-centric neurosurgical care in Gurgaon, provides comprehensive evaluation, accurate diagnosis, and effective treatment for SSCM and related spinal disorders. Whether you’re dealing with persistent back pain, neurological symptoms, or a known spinal anomaly, you can trust Dr. Kathuria for compassionate and expert care every step of the way.