Diastematomyelia in Congenital Scoliosis: A Report of Two Cases
Diastematomyelia in Congenital Scoliosis: A Report of Two Cases
DOI 10.1007/s00586-014-3218-x
CASE REPORT
Gheorghe Burnei
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Fig. 2 CT exam showed the presence of a diastematomyelic septum located at L2–L3, and an abnormality of shape and position of the vertebral
arch
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Fig. 5 X-rays and CT-3D images. We noticed the presence of a congenital kyphoscoliosis and a T12 diastematomyelic septum
Fig. 6 During surgery, the diastematomyelic septum was removed and T9–L3 posterior in situ fusion with rib allografts was performed
Fig. 7 Clinical and X-rays exams 3 years after surgery showed a stabile scoliotic curve and a spontaneous correction of the kyphotic curve. The
patient presented no altering in the clinical status after the removal of the diastematomyelic septum
deficit, sometimes to complete paralysis of lower limbs. The therapeutic algorithm should be a single-stage sur-
That’s why it would be justified to take surgical attitude if gery addressed first to the diastematomyelic septum and
diastematomyelia is diagnosed, even if asymptomatic [9]. next to the scoliotic curve correction if it reaches a 30°–40°
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Cobb angle. This attitude is even more effective as the congenital scoliosis without surgical indication should be
progressive potential is higher. The potential of increasing carefully monitored. The most sensitive sign of developing
the curve is related to the asymmetry in growth potential on any complications requires surgery. Compliance with
the convex and concave sides of the curve [10]. Not treatment algorithm that requires mandatory initial
respecting these steps may cause irreversible and irrepa- approach of diastematomyelia and next the congenital
rable damages. scoliosis ensures safety to the patient and surgeon.
It is known that about 25 % of congenital scoliosis cases
have no progressive potential and do not require surgery. Acknowledgments The senior author GB operated all the cases
mentioned in our clinics experience.
Our indication for such patients, if they associate the pre-
sence of diastematomyelia, is the expectative-evaluation Conflict of interest None of the authors has any potential conflict of
attitude by clinical and radiological evaluation. If we face a interest.
congenital scoliosis without indication for surgery, but
there is evidence of dynamic growth in size of the diaste-
matomyelic septum with risk of occurrence of phenomena References
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