Artikel
Surgical technique and outcome in patients with diastematomyelia
Chirurgische Technik und Behandlungsergebnisse bei Patienten mit Diastematomyelie
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Autoren
Veröffentlicht: | 4. Mai 2005 |
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Gliederung
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Objective
Diastematomyelia is a complexe and rare disease. Therefore different techniques are used for surgical treatment. We report on surgical technique and outcome following operative treatment in 10 patients with diastematomyelia, treated in a single neurosurgical unit.
Methods
10 consecutive patients (7 female and 3 male) between 5 months and 50 years of age were surgically treated for diastematomyelia. Indication for treatment was neurological deterioration due to progressive tethered cord syndrome in all patients. 6 patients were primarily treated for spina bifida, and 4 patients for other complex spinal malformations. The diastema was located in the lumbar spinal canal in 9 patients and in the thoracic spinal canal in 1 patient. One patient suffered from 2 separated lesions in the lumbar spinal canal. Surgical treatment consisted of complete resection of the diastema and associated soft tissue as well as reconstruction of the ventral and dorsal dura mater.
Results
Sufficient untethering and resection of the diastema was achieved in all treated patients. In one patient, recurrence of the diastema was documented by MRI, but didn't significantly affect the further course. In one adult patient, a CSF leak occured. Surgical revision had to be performed.
Conclusions
Complete resection of the diastema and of all associated soft tissue around the lesion was found to be important in order to achieve sufficient detethering. Resection and reconstruction of the ventral dural layer seems to be necessary to prevent recurrence of the diastema.