DIAGNOSIS AND TREATMENTOF DIASTEMATOMYELIA IN CHILDREN

Abstract

Objective. To analyze neurological status of patients, radiological presentation of disease, and an incidence rate of diasematomyelia’s association with skin and musculoskeletal disorders.

Material and Methods. The study included 20 patients with diastematomyelia aged from 1 to 18 years. Diagnosis was based on a case history, clinical examinations, spine radiography in coronal and sagittal planes, CT (20 cases), CT myelography (1 case), MRI (20 cases), and neurophysiological study (electroneuromyography of lower extremities). Septum resection was indicated in 17 children.

Results. All patients had cutaneous changes along the midline of the back such as hypertrichosis, hemangiomas, and dermal sinuses. Neurological symptoms were noted in 17 patients: lower paraparesis in 11, urinary incontinence in 2, monoparesis in 4, and pyramidal insufficiency in 2 patients. Three patients did not show any neurological deficit. Orthopedic examination revealed spinal deformities of various degrees of severity.

Conclusion. Resection of the septum in patients with diastematomyelia should be the first stage of surgical scoliosis correction and precede orthopedic correction of low extremity deformity. Patients having neither neurological deficit no orthopedic deterioration should be followed up, and in case of pathological symptoms augmenting or elecroneuromiography changing a question of surgical treatment should be regarded.