Split Cord Malformation

Split Cord Malformation

Split Cord Malformation (SCM) is a rare congenital condition in which the spinal cord is divided longitudinally into two hemicords, often separated by a bony, fibrous, or cartilaginous septum. These two hemicords may lie in separate dural sacs (Type I) or in a single sac (Type II). This malformation occurs during embryonic development and is usually associated with other spinal dysraphic anomalies, including tethered cord, dermal sinus tracts, lipomas, or vertebral defects. SCM can cause progressive neurological deterioration, scoliosis, bladder dysfunction, gait disturbance, and lower limb weakness, especially if not diagnosed and treated early. 🌍 Bangladesh Perspective: SCM is Underdiagnosed and Undertreated In Bangladesh, Split Cord Malformation is often underdiagnosed due to limited access to high-quality spinal imaging (MRI) and lack of awareness among general physicians. Children often present late with paralysis, foot deformities, incontinence, or spinal infections due to associated dermal sinus tracts. Many parents are unaware that early surgery can prevent these severe complications. At NINS and Bangladesh Paediatric Neurocare Centre, Dr. Md. Nafaur Rahman provides expert evaluation and microsurgical correction of SCM, helping children across Bangladesh achieve improved mobility and quality of life. 🧬 Classification of Split Cord Malformation SCM is classified into two main types: Type I (Complex SCM) Two hemicords enclosed in separate dural sacs Separated by a rigid bony or cartilaginous spur Usually more symptomatic Type II (Simple SCM) Two hemicords within a single dural sac Divided by a fibrous band Often associated with fewer symptoms Both types may cause tethering of the spinal cord and result in neurological deficits as the child grows. πŸ§’ Clinical Signs & Symptoms Symptoms usually progress with age due to spinal cord tethering and nerve traction: Weakness or spasticity in one or both legs Abnormal gait, frequent falls Foot deformities (clubfoot, high arch, toe walking) Loss of bladder or bowel control Back pain or stiffness Visible skin markers: Hairy patch Dimple Skin tag Swelling or lipoma over midline spine Scoliosis or spinal deformity In some cases, SCM may be discovered incidentally during evaluation for other spinal anomalies. πŸ” Diagnostic Evaluation 🧠 MRI Spine – Gold Standard Visualizes the split cord, its type, and associated anomalies (tethered cord, syrinx, lipoma, etc.) 🦴 CT Spine Essential to detect bony spur in Type I SCM πŸ§ͺ Neurological & Urological Tests Urodynamic studies if bladder symptoms are present Clinical evaluation of lower limb power and reflexes πŸ› οΈ Surgical Treatment Surgical intervention is recommended to: Remove the bony/fibrous spur Detether the spinal cord Reconstruct the dural sac to allow free spinal cord movement Prevent future neurological deterioration Microsurgical correction under neurophysiological monitoring ensures safety and precision, especially in complex Type I SCM. πŸ”„ Post-Surgical Outcomes Excellent results when diagnosed and treated early Neurological symptoms often stabilize or improve Bladder function may improve if treated before irreversible damage Requires long-term follow-up to assess: Spinal alignment Neurological function Risk of retethering Rehabilitation may be necessary for children with motor deficits or limb deformities. πŸ‘¨β€βš•οΈ Why Choose Dr. Md. Nafaur Rahman? One of Bangladesh’s top experts in complex pediatric spinal dysraphism Experienced in managing all forms of Split Cord Malformation Performs microsurgical correction with precision at NINS and Bangladesh Paediatric Neurocare Centre Offers comprehensive care: Pediatric neurology Pediatric orthopedics Urology and physiotherapy support Trusted by families from all over Bangladesh for safe, child-friendly care πŸ“ž Book Your Appointment Today Dr. Md. Nafaur Rahman Assistant Professor, Department of Pediatric Neurosurgery, National Institute of Neurosciences & Hospital (NINS) Chief Consultant, Bangladesh Paediatric Neurocare Centre πŸ“ž Call for Serial: 01912988182 | 01607033535 🌐 Visit: www.neurosurgeonnafaur.com

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