Segmental Spinal Dysgenesis–“Redefined”
- Author:
Amarnath CHELLATHURAI
1
;
Balaji AYYAMPERUMAL
;
Rajakumari THIRUMARAN
;
Gopinathan KATHIRVELU
;
Priya MUTHAIYAN
;
Sivakumar KANNAPPAN
Author Information
- Publication Type:Original Article
- Keywords: Spinal cord; Scoliosis; Magnetic resonance imaging; Segmental spinal dysgenesis
- MeSH: Child; Congenital Abnormalities; Humans; Magnetic Resonance Imaging; Notochord; Observational Study; Retrospective Studies; Scoliosis; Silver Sulfadiazine; Spinal Canal; Spinal Cord; Spine
- From:Asian Spine Journal 2019;13(2):189-197
- CountryRepublic of Korea
- Language:English
- Abstract: STUDY DESIGN: Retrospective single institutional observational study. PURPOSE: Segmental spinal dysgenesis (SSD), a complex spinal dysraphic state caused by notochord malformation disorders, is named after its morphological presentation where a spine segment is dysgenetic, malformed or absent. This study’s objective was to examine and reassess SSD imaging findings and correlate them with an embryological explanation. OVERVIEW OF LITERATURE: Scott and his colleagues defined SSD as segmental agenesis or dysgenesis of the lumbar or thoracolumbar vertebrae and underlying spinal cord. Tortori-Donati and his colleagues defined it as a morphologic continuum ranging from hypoplasia to an absent spinal cord segment. METHODS: Fifteen children, whose imaging findings and clinical features were consistent with SSD, were included in the study. Magnetic resonance imaging (MRI) was performed per institutional spine protocol. RESULTS: Five children (33.3%) presented with a high-ending bulbous cord with no caudal segment, six (40%) presented with a dorsal or lumbar segmental dysgenetic cord with a low-lying, bulky caudal cord but without significant spinal canal narrowing, and four (26.6%) presented with segmental caudal dysgenesis with severe kyphoscoliosis, gibbus deformity, and spinal canal narrowing with a normal distal segment (normal or low-lying). CONCLUSIONS: SSD is a complex spinal anomaly in children requiring clinical-radiological assessment followed by multidisciplinary management based on the extent and severity of the dysgenetic cord and the type of SSD. MRI plays a crucial role in both diagnosing and classifying SSD prior to surgical treatment to prevent further impairment.
