ENGİN IHSAN TURAN, FUNDA PİYADE, ONUR SARBAN, SEMRA IŞIK, AYÇA SULTAN ŞAHİN
Comprehensive Medicine - 2024;16(2):128-130
Diastematomyelia, a congenital spinal anomaly characterized by a longitudinal split of the spinal cord into two hemicords, poses significant clinical and surgical challenges. This condition, often associated with scoliosis and other neural tube defects, necessitates careful diagnostic and therapeutic approaches to prevent neurological deterioration and improve patient outcomes. Understanding the embryological development and manifestations of diastematomyelia is crucial for timely diagnosis and management. We report on an 11-month-old female patient with no history of systemic diseases, presenting with significant scoliosis but no neurological deficits. Diagnostic imaging, including computerized tomography, revealed no thoracic involvement but confirmed the presence of Type 1 diastematomyelia, characterized by two dural sacs separated by a bony septum. Anesthetic management was tailored to address the complexities of the condition, involving inhalation anesthesia with sevoflurane, followed by remifentanil and propofol for neuromonitoring. Surgical intervention focused on the unification of the separated dural sacs, with careful intraoperative monitoring to avoid neurological complications. The patient’s postoperative course was uneventful, and she was transferred to the pediatric intensive care unit for recovery. The management of dias- tematomyelia, particularly in pediatric patients, requires a multidisciplinary approach, encompassing accurate diagnostic imaging, specialized anesthetic management, and surgical precision. The case further illustrates the necessity of a detailed examination and a comprehensive management strategy, advocating for early intervention and tailored care to optimize patient outcomes in the context of this complex congenital condition.
