title: Expert's comment concerning Grand Rounds case entitled "vertebral column resection for complex congenital kyphoscoliosis and type I split cord malformation" (Hua Hui, Zhen-Xing Zhang, Tuan-Min Yang, Bao-Rong He, Ding-Jun Hao).
abstract: BACKGROUND
  Comment on a case report on a challenging case of a severe spinal congenital deformity with a type I split spinal cord malformation (SSCM) in a 23-year-old with initial neurological symptoms.
  
  
  METHODS
  The patient was treated with a halo gravity traction over one month. A posterior vertebral column resection cephalad to the bony spur at T12 was done and moderate frontal and sagittal plane curve correction was achieved without resection of the bony spur.
  
  
  CONCLUSIONS
  In conclusion, despite a quite clear recommendation in the current literature to first surgically address the type 1 SSCM prior to correction of any spinal deformity, the authors of the present case chose to leave the bony spur. Still it remains to be seen if in this very case the spur will become clinically apparent in the future or not. As long as larger studies on curve correction without spur resection in SSCM are not available, spur resection prior to any type of curve correction remains the golden standard.
authors.affiliation: Orthopädische Klinik II Wirbelsäulenchirurgie, St. Franziskus-Hospital, Hohenzollernring 72, 48145, Münster, Germany, ulf.liljenqvist@sfh-muenster.de.
authors.forename: Ulf R
authors.initials: UR
authors.lastname: Liljenqvist
mesh_terms: D005260:Female; D006801:Humans; D007738:Kyphosis / Q000601:surgery*; D012600:Scoliosis / Q000601:surgery*; D013116:Spinal Cord / Q000002:abnormalities* / Q000601:surgery*