Ozcan Kaya1, Onur Levent Ulusoy2, Selhan Karadereler2, Azmi Hamzaoglu2. 1. Istanbul Gelisim University, Istinye University Bahcesehir Liv Hospital, 34513, Avcilar-Esenyurt/Istanbul, Turkey. ozcankaya.md@gmail.com. 2. Istanbul Spine Center, Istanbul Florence Nightingale Hospital, Sisli/Istanbul, Turkey.
Abstract
PURPOSE: Spine duplication is a very rare condition with the literature being composed of only case reports. All previously reported cases were thoracolumbar spine duplications. Here, we report cervicothoracic spine duplication in a neurological intact male. According to our knowledge, it is the first case in the literature of cervicothoracic spine duplication. CLINICAL PRESENTATION: A 3-year-old patient presented to a primary physician with a complaint of short stature. He was referred to our department with suspected spinal deformity. Computerized tomography imaging revealed anterior bony structure duplication and posterior dysmorphic elements at the C5-T9 levels. Magnetic resonance imaging revealed a syrinx cavity which splits cord at the duplication level and the relation of the syrinx with posterior mediastinum through anterior bone defect. He was followed up for 10 years. CONCLUSION: In the literature, spine duplication has been classified as a severe form of split cord malformation because of the concurrence of bone duplication with split spinal cord malformation (SCM). This case presents a distinct form of SCM which shows non-duplicated dural tube as unclassified and cervicothoracic duplication level without neurological deficitis. Treatment of SCM was based on removal of splitting fibrous/osseous process. Neurologic intact spine duplication could be followed up without surgical intervention.
PURPOSE: Spine duplication is a very rare condition with the literature being composed of only case reports. All previously reported cases were thoracolumbar spine duplications. Here, we report cervicothoracic spine duplication in a neurological intact male. According to our knowledge, it is the first case in the literature of cervicothoracic spine duplication. CLINICAL PRESENTATION: A 3-year-old patient presented to a primary physician with a complaint of short stature. He was referred to our department with suspected spinal deformity. Computerized tomography imaging revealed anterior bony structure duplication and posterior dysmorphic elements at the C5-T9 levels. Magnetic resonance imaging revealed a syrinx cavity which splits cord at the duplication level and the relation of the syrinx with posterior mediastinum through anterior bone defect. He was followed up for 10 years. CONCLUSION: In the literature, spine duplication has been classified as a severe form of split cord malformation because of the concurrence of bone duplication with split spinal cord malformation (SCM). This case presents a distinct form of SCM which shows non-duplicated dural tube as unclassified and cervicothoracic duplication level without neurological deficitis. Treatment of SCM was based on removal of splitting fibrous/osseous process. Neurologic intact spine duplication could be followed up without surgical intervention.
Authors: Michael Glotzbecker; Charles Johnston; Patricia Miller; John Smith; Francisco Sanchez Perez-Grueso; Regina Woon; John Flynn; Meryl Gold; Sumeet Garg; Gregory Redding; Patrick Cahill; John Emans Journal: Spine (Phila Pa 1976) Date: 2014-09-01 Impact factor: 3.468