{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T07:59:01Z","timestamp":1648540741004},"reference-count":5,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nSplit cord malformations (SCMs) are uncommon congenital anomalies. They can be divided into Type 1 (bony septum and two separate dural sheaths) and Type 2 (fibrous septum and a single dural sheath).[1,2,4] Rarely,SCM can be associated with orthopedic anomalies (mostly seen in older children), such as scoliosis, followed by kyphosis, and\/or both.[1-3] Conversely, patients with congenital scoliosis have 40% risk of congenital underlying neural deformities, with 16.3% attributed to SCM.[1,4] Those with thoracic or lumbosacral SCM may have congenital tethering lesions, predominantly consisting of intradural lipomas.[3,4] Surgery is optimally performed in two stages: first, removal of the spinal septum and untethering of the cord, and second, correction of the kyphosis, scoliosis, and\/or both.[1-5]<\/jats:p>\n<\/jats:sec>\n\nCase Description: <\/jats:title>\nIn this video, a 44-year-old female initially presented after having progressively developed kyphoscoliosis since childhood. Three months before presentation, she had developed increased left lower extremity pain with hypoesthesia followed 1 month later by the onset of the left lower extremity monoplegia (0\/5). The computed tomography and magnetic resonance imaging studies revealed a SCM at the L3 level with bony and membranous septum, accompanied by an intradural lipoma, and tethered cord. She underwent a two- stage procedure; first, removal of the bony and membranous septum, resection of the intradural lipoma, and untethering of the cord; second, she had correction of the kyphoscoliosis. Postoperatively, although the pain and sensory deficits improved, the left lower extremity monoplegia remained.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nSCM is a rare cause of spinal deformity. If left untreated, the associated neurological deficits may progress. Treatment should include a two-staged approach; first, the bony and membranous septum should be removed followed by lipoma resection and untethering the cord with adequate cord decompression, while second, a fusion may be performed to address attendant kyphoscoliosis.<\/jats:p>\n<\/jats:sec>\n\nKeywords: <\/jats:title>\nIntradural lipoma, Kyphoscoliosis, Split cord malformation, Tethered cord<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_331_2020","type":"journal-article","created":{"date-parts":[[2020,6,27]],"date-time":"2020-06-27T06:11:00Z","timestamp":1593238260000},"page":"172","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Combined Type 1 and 2 split cord malformations, kyphoscoliosis, tethered cord, and a lipoma"],"prefix":"10.25259","volume":"11","author":[{"given":"Turki","family":"Elarjani","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sami","family":"Khairy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King Abdulaziz Medical City, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wael","family":"Alshaya","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King Abdulaziz Medical City, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2020,6,27]]},"reference":[{"key":"10.25259\/SNI_331_2020\/ref-1","doi-asserted-by":"crossref","first-page":"e601","DOI":"10.1016\/j.wneu.2020.01.092","article-title":"Split cord malformation: Presentation, management, and surgical outcome","volume":"136","author":"Alnefaie","year":"2020","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_331_2020\/ref-2","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1007\/s00381-013-2115-7","article-title":"Split cord malformation Types I and II: A personal series of 131 patients","volume":"29","author":"Er\u015fahin","year":"2013","journal-title":"Childs Nerv Syst"},{"key":"10.25259\/SNI_331_2020\/ref-3","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.1007\/s00586-013-3044-6","article-title":"Vertebral column resection for complex congenital kyphoscoliosis and Type I split spinal cord malformation","volume":"23","author":"Hui","year":"2014","journal-title":"Eur Spine J"},{"key":"10.25259\/SNI_331_2020\/ref-4","doi-asserted-by":"crossref","first-page":"588","DOI":"10.2106\/00004623-198466040-00015","article-title":"Occult intraspinal anomalies and congenital scoliosis","volume":"66","author":"McMaster","year":"1984","journal-title":"J Bone Joint Surg Am"},{"key":"10.25259\/SNI_331_2020\/ref-5","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1227\/00006123-199209000-00011","article-title":"Split cord malformation: Part II: Clinical syndrome","volume":"31","author":"Pang","year":"1992","journal-title":"Neurosurgery"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/combined-type-1-and-2-split-cord-malformations-kyphoscoliosis-tethered-cord-and-a-lipoma\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/combined-type-1-and-2-split-cord-malformations-kyphoscoliosis-tethered-cord-and-a-lipoma\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,6,27]],"date-time":"2020-06-27T06:11:02Z","timestamp":1593238262000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/combined-type-1-and-2-split-cord-malformations-kyphoscoliosis-tethered-cord-and-a-lipoma\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,27]]},"references-count":5,"alternative-id":["10.25259\/SNI_331_2020"],"URL":"https:\/\/doi.org\/10.25259\/sni_331_2020","relation":{},"ISSN":["2152-7806"],"issn-type":[{"value":"2152-7806","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,27]]},"article-number":"172"}}