Diastematomylia Between Diagnosis And Surgical Decision: Experience Of Our Department

Abstract

Introduction: Spinal Dysraphia Is A Malformative Complex Of The Nervous System And These Meningeal Envelopes, The Term Diastematomyelia Defines A Malformation Of The Spinal Cord Comprising A Vertically Elongated Medullary Cleft Dividing It Into Two Spinal Cord. This Medullary Cleft Coexists With A Bone Cartilaginous Or Fibrous Septum Developed From The Vertebral Body And Invaginating The Dura Mater Over The Entire Height Of The Cleft. Each Spinal Cord Contains Its One Dural Sheath. Materials And Methods: During 06 Years From May 2017 To September 2022, We Hospitalized In Neurosurgery 18 Cases Of Diastematomyelia. Discussion: Surgical Release Of A Tethered Low Marrow And Resection Of The Spur Are Offered For Symptomatic Children Or Children With Scoliosis. The Surgery Is Controversial; Some Prefer Preventive Surgery During The First Two Years, Others Rather Keep A Conservative Approach Given The Risk Of Surgery And The Significant Number Of Children Who Remain Asymptomatic For A Long Time. In Our Series, All The Patients Were Operated, For Resection Of The Spur, And For Release Of A Attached Low Spinal Cord. Frequency: 18 Cases / 184 Spina Bifida = 9.78% Associated Malformations (Scoliosis, Thoracic Deformity, Etc.) Are Infrequent. The Surgery Consists Of Removing The Bone Epron All The Way Up And Reintroducing The Two Spinal Cord In A Single Dural Sheath. Conclusion: Diastematomyelia And A Malformation Quite Often Found With Spinal Dysraphia, It Is More Frequently Accompanied By Bone Malformations Of The Vertebral Bodies Apart From The Surgical Treatment Which Is Much More Complex, Their Clinical Expression And Their Management Merges With Those Of The Dysraphia