Spinal dysraphisms of the cervicothoracic region in childhood.
OBJECTIVE
Spinal dysraphisms are the most common congenital anomalies of the CNS. Spinal dysraphism (SD) of cervical and upper thoracic region are rare, demonstrating distinct clinical and structural configurations compared to lumbar counterparts.


METHODS
In Haydarpasa Numune Hospital, a total of 7 cases (3 male and 4 female) ranging between 20 days to 9 years of age with cervicothoracic SD were operated on between 2002 and 2008. The sacs were located in the cervical and thoracic region in 4 and 3 of the cases, respectively. The associated anomalies were diagnosed in 3 cases, including SCM type 2, Chiari type 2, hyrocephalus and hydromyelia. All cases underwent surgical treatment that involves excision of the sac and intradural exploration providing untethering of the spinal cord. Postoperative follow up of these patients was uneventful and neither neurological deficits nor complications were observed.


CONCLUSIONS
Cervicothoracic SD has more favorable outcome in respect to neurological, orthopaedic and urologic problems compared to lumbar counterparts. In order to prevent forthcoming neurological deterioration, surgical treatment consisting of intradural exploration of the lesion, untethering of the spinal cord and excision of potential adhesions should be performed in the early period.
Haydarpaşa Numune Research and Educational Hospital, Clinic of Neurosurgery, Istanbul, Turkey. morakdogen@gmail.com
Metin
M
Orakdogen
Cezmi Cagri
CC
Turk
Mehmet
M
Ersahin
Necat
N
Biber
Zafer
Z
Berkman
D002574:Cervical Vertebrae; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D016135:Spinal Dysraphism / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D013904:Thoracic Vertebrae; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome