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Split cord malformation in adults: Literature review and classification.

Publication ,  Journal Article
Karim Ahmed, A; Howell, EP; Harward, S; Sankey, EW; Ehresman, J; Schilling, A; Wang, T; Pennington, Z; Gray, L; Sciubba, DM; Goodwin, CR
Published in: Clin Neurol Neurosurg
June 2020

The objective of this study was to summarize the available literature describing the presentation, diagnostic evaluation, and management for adults with Type 1 and Type 2 split spinal cord malformations. A review of the literature was performed using the CINAHL, PubMed, Embase, and Web of Science database, alongside all associated bibliographies, to include studies describing Type 1 and Type 2 split cord malformations diagnosed in patients above the age of 18. All relevant studies of split cord malformations were included, regardless of the year published and terminology used to describe the dysraphism. Clinical case series (≥ 2 patients), cohort studies, and review articles comprising adult patients with radiographically diagnosed diastematomyelia, diplomyelia, or dimyelia were included (Class of Evidence I-IV). A total of 17 unique articles, describing 146 unique adult spinal cord malformation subjects, were included. The most common associated condition was tethered cord syndrome (59.8 %). Operative management for symptomatic split cord malformation was performed in 72.3 % of cases. For those with preoperative neurologic deficits, operative management resulted in symptomatic improvement in 96.6 %, compared to 0 % conservative management (p < 0.05). For those with pain alone, operative management resulted in improvement of 91.1 %, compared to 12.5 % conservative management (p < 0.05). To date, this is the only literature review to include all split cord malformations (SCM Types I and II) presenting in adulthood, with clinical characteristics, associated conditions, and long-term treatment outcomes.

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Published In

Clin Neurol Neurosurg

DOI

EISSN

1872-6968

Publication Date

June 2020

Volume

193

Start / End Page

105733

Location

Netherlands

Related Subject Headings

  • Treatment Outcome
  • Spinal Cord Diseases
  • Spinal Cord
  • Neurosurgical Procedures
  • Neurology & Neurosurgery
  • Magnetic Resonance Imaging
  • Humans
  • 3209 Neurosciences
  • 3202 Clinical sciences
  • 1109 Neurosciences
 

Citation

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Chicago
ICMJE
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Karim Ahmed, A., Howell, E. P., Harward, S., Sankey, E. W., Ehresman, J., Schilling, A., … Goodwin, C. R. (2020). Split cord malformation in adults: Literature review and classification. Clin Neurol Neurosurg, 193, 105733. https://doi.org/10.1016/j.clineuro.2020.105733
Karim Ahmed, A., Elizabeth P. Howell, Stephen Harward, Eric W. Sankey, Jeffrey Ehresman, Andrew Schilling, Timothy Wang, et al. “Split cord malformation in adults: Literature review and classification.Clin Neurol Neurosurg 193 (June 2020): 105733. https://doi.org/10.1016/j.clineuro.2020.105733.
Karim Ahmed A, Howell EP, Harward S, Sankey EW, Ehresman J, Schilling A, et al. Split cord malformation in adults: Literature review and classification. Clin Neurol Neurosurg. 2020 Jun;193:105733.
Karim Ahmed, A., et al. “Split cord malformation in adults: Literature review and classification.Clin Neurol Neurosurg, vol. 193, June 2020, p. 105733. Pubmed, doi:10.1016/j.clineuro.2020.105733.
Karim Ahmed A, Howell EP, Harward S, Sankey EW, Ehresman J, Schilling A, Wang T, Pennington Z, Gray L, Sciubba DM, Goodwin CR. Split cord malformation in adults: Literature review and classification. Clin Neurol Neurosurg. 2020 Jun;193:105733.

Published In

Clin Neurol Neurosurg

DOI

EISSN

1872-6968

Publication Date

June 2020

Volume

193

Start / End Page

105733

Location

Netherlands

Related Subject Headings

  • Treatment Outcome
  • Spinal Cord Diseases
  • Spinal Cord
  • Neurosurgical Procedures
  • Neurology & Neurosurgery
  • Magnetic Resonance Imaging
  • Humans
  • 3209 Neurosciences
  • 3202 Clinical sciences
  • 1109 Neurosciences