Split Cord Malformation (SCM) is a rare congenital condition in which the spinal cord is split into two distinct hemicords. This anomaly can lead to significant neurological issues if left untreated. Although commonly diagnosed in childhood, SCM may also present in adults who experience neurological symptoms or undergo spinal imaging for unrelated issues.
In this article, Dr. Vijaymahantesh Pujari, an experienced neurosurgeon in Hubli, provides a detailed overview of SCM, its types, clinical features, diagnosis, and available treatment options.
What is Split Cord Malformation?
Split Cord Malformation is a developmental anomaly where the spinal cord is divided longitudinally into two parts. These hemicords may be contained in separate or shared protective coverings (dural sacs), and may be divided by rigid or flexible structures. This condition is often associated with other spinal abnormalities such as tethered cord or scoliosis.
Types of Split Cord Malformation
SCM is classified into two major types, based on the anatomical differences:
🔹 Type I SCM
- Two hemicords, each enclosed in its own dural sac
- Separated by a bony or cartilaginous septum (rigid)
- More commonly associated with other anomalies like tethered cord, scoliosis
More likely to cause symptoms
🔹 Type II SCM
- Two hemicords located in a single dural sac
- Separated by a fibrous (non-rigid) septum
- Often clinically less severe
- May remain asymptomatic or present later in life
As a leading neurosurgeon in Hubli, Dr. Vijaymahantesh Pujari has evaluated and treated several patients with both types of SCM, tailoring the approach based on the individual’s symptoms and imaging findings.
Clinical Features of Split Cord Malformation
Symptoms of SCM vary widely and depend on the severity and type. Common clinical signs include:
- Neurological deficits such as muscle weakness or altered sensation
- Gait disturbances or imbalance while walking
- Back pain or spinal deformities like scoliosis
- Cutaneous stigmata (skin changes) such as:
1. Hairy patches (hair tufts)
2. Skin dimples
3. Subcutaneous lipomas
- Bladder or bowel dysfunction, especially in more severe or long-standing cases
Dr. Vijaymahantesh Pujari stresses the importance of early detection, particularly in children with visible skin abnormalities over the spine or unexplained walking difficulties.
Diagnosis
📌 MRI (Magnetic Resonance Imaging)
MRI is the gold standard for diagnosing SCM. It clearly visualizes:
- The split in the spinal cord
- Type of septum
- Associated abnormalities like tethered cord or syrinx
📌 CT Scan (Computed Tomography)
CT imaging is particularly useful for assessing bony structures in Type I SCM, helping to plan surgical intervention when needed.
Treatment of Split Cord Malformation
🔹 When is Surgery Needed?
Not all SCM cases require surgery. Surgical intervention is indicated when:
- The patient is symptomatic
- There are progressive neurological deficits
- Imaging shows significant tethering or cord compression
🔹 Goals of Surgery
As per Dr. Vijaymahantesh Pujari, the primary surgical objectives include:
- Untethering the spinal cord
- Removing the septum (bony or fibrous)
- Decompression of neural elements
- Stabilizing the spine if needed
Surgical correction aims to prevent further neurological decline, especially in children during growth or in adults with worsening symptoms.
Why Choose Dr. Vijaymahantesh Pujari in Hubli?
Dr. Vijaymahantesh Pujari is one of the few neurosurgeons in Hubli with extensive experience in congenital spinal anomalies, including Split Cord Malformation. He offers comprehensive evaluation, advanced imaging interpretation, and state-of-the-art surgical treatment tailored to each patient’s needs.
His patient-centered approach and commitment to neurological health have made him a preferred choice for individuals seeking expert spinal care in the region.
Final Words
Split Cord Malformation may be rare, but it is treatable, especially when identified early. If you or your child has symptoms like unexplained leg weakness, abnormal posture, skin dimples over the back, or bladder disturbances, a thorough neurological evaluation is crucial.
Dr. Vijaymahantesh Pujari, trusted neurosurgeon in Hubli, offers expert diagnosis and treatment for SCM and other complex spinal conditions.