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Tanimoto R, Ikuse T, Ito N, Sato H, Kasai Y, Yamada H, Saito N, Iwasaki T, Ikeno M, Suganuma H, Hisata K, Shoji H, Kudo T, Sakamoto K, Shimoji K, Kondo A, Shimizu T. A Case of Neonate with Split Cord Malformation Presenting with Hypoplasia of the Left Lower Extremity. Medicina (Kaunas) 2023; 59:medicina59040726. [PMID: 37109684 PMCID: PMC10144382 DOI: 10.3390/medicina59040726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/30/2023] [Accepted: 04/05/2023] [Indexed: 04/29/2023]
Abstract
The frequency of split cord malformation (SCM) is approximately 1 in 5000 births; however, patients are rarely diagnosed with SCM in the neonatal period. Moreover, there have been no reports of SCM with hypoplasia of the lower extremities at birth. A 3-day-old girl was transferred to our hospital for a thorough examination of hypoplasia of the left lower extremity and lumbosacral abnormalities detected after birth. The spinal magnetic resonance imaging (MRI) revealed a split spinal cord in a single dural tube. Based on the MRI findings, the patient was diagnosed with SCM type II. Following discussions with the parents, pediatricians, neurosurgeons, psychologists, and social workers, we decided to perform untethering to prevent further neurological impairment after achieving a sufficient body weight. The patient was discharged on day 25 of life. Early diagnosis and intervention may improve the neurological prognosis in terms of motor function, bladder and bowel function, and superficial sensation; thus, clinicians should report infrequent findings that may lead to SCM diagnosis. SCM should be differentiated in patients with left-right differences in the appearance of the lower extremity, particularly in those with lumbosacral abnormalities.
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Affiliation(s)
- Ryosuke Tanimoto
- Department of Pediatrics, Juntendo University Faculty of Medicine, 3-1-3 Hongo, Bunkyo, Tokyo 113-8431, Japan
| | - Tamaki Ikuse
- Department of Pediatrics, Juntendo University Faculty of Medicine, 3-1-3 Hongo, Bunkyo, Tokyo 113-8431, Japan
| | - Natsuki Ito
- Department of Pediatrics, Juntendo University Faculty of Medicine, 3-1-3 Hongo, Bunkyo, Tokyo 113-8431, Japan
| | - Hiroyuki Sato
- Department of Pediatrics, Juntendo University Faculty of Medicine, 3-1-3 Hongo, Bunkyo, Tokyo 113-8431, Japan
| | - Yuriha Kasai
- Department of Pediatrics, Juntendo University Faculty of Medicine, 3-1-3 Hongo, Bunkyo, Tokyo 113-8431, Japan
| | - Hiromichi Yamada
- Department of Pediatrics, Juntendo University Faculty of Medicine, 3-1-3 Hongo, Bunkyo, Tokyo 113-8431, Japan
| | - Nobutomo Saito
- Department of Pediatrics, Juntendo University Faculty of Medicine, 3-1-3 Hongo, Bunkyo, Tokyo 113-8431, Japan
| | - Tomohiro Iwasaki
- Department of Pediatrics, Juntendo University Faculty of Medicine, 3-1-3 Hongo, Bunkyo, Tokyo 113-8431, Japan
| | - Mitsuru Ikeno
- Department of Pediatrics, Juntendo University Faculty of Medicine, 3-1-3 Hongo, Bunkyo, Tokyo 113-8431, Japan
| | - Hiroki Suganuma
- Department of Pediatrics, Juntendo University Faculty of Medicine, 3-1-3 Hongo, Bunkyo, Tokyo 113-8431, Japan
| | - Ken Hisata
- Department of Pediatrics, Juntendo University Faculty of Medicine, 3-1-3 Hongo, Bunkyo, Tokyo 113-8431, Japan
| | - Hiromichi Shoji
- Department of Pediatrics, Juntendo University Faculty of Medicine, 3-1-3 Hongo, Bunkyo, Tokyo 113-8431, Japan
| | - Takahiro Kudo
- Department of Pediatrics, Juntendo University Faculty of Medicine, 3-1-3 Hongo, Bunkyo, Tokyo 113-8431, Japan
| | - Koichiro Sakamoto
- Department of Neurosurgery, Juntendo University Faculty of Medicine, 3-1-3 Hongo, Bunkyo, Tokyo 113-8431, Japan
| | - Kazuaki Shimoji
- Department of Neurosurgery, International University of Health and Welfare Narita Hospital, 852 Hatakeda Narita, Chiba 286-0124, Japan
| | - Akihide Kondo
- Department of Neurosurgery, Juntendo University Faculty of Medicine, 3-1-3 Hongo, Bunkyo, Tokyo 113-8431, Japan
| | - Toshiaki Shimizu
- Department of Pediatrics, Juntendo University Faculty of Medicine, 3-1-3 Hongo, Bunkyo, Tokyo 113-8431, Japan
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