1320. Pediatric Diastematomyelia: Describing a Rare Patient Population

Authors: Elizabeth Howell; Ali Ahmed; Taylor Purvis; Eric Sankey, MD; Timothy Wang, MD; Daniel Sciubba, MD; Carrie Muh, MD, MS; C. Rory Goodwin, MD, PhD (Durham, NC)

Introduction:

Split cord malformation, or diastematomyelia, is a closed spinal dysraphism theorized to arise from dysfunctional gastrulation during early embryogenesis. In the pediatric population, this abnormality frequently coincides with additional congenital anomalies. Despite the need for surgical intervention in many symptomatic patients, the rarity of this condition has resulted in a paucity of data regarding its optimal management. In this study, we sought to compile and analyze cases of pediatric diastematomyelia to further characterize the patients and postoperative outcomes within this rare population.

Methods:

Data for this study was compiled using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. All pediatric patients with a documented ICD-9 code 742.51, corresponding to “diastematomyelia,” were included. 

Results:

Seventeen patients who fit the above criteria were available in the NSQIP database between the years of 2012-2014. Notably, 12 of these patients carried an ICD code corresponding to an additional congenital malformation. Mean patient age was 9.68 years (SD = 5.77). With the exception of two emergent cases, most operations were performed electively, and the majority of cases were performed by pediatric neurosurgeons. Seven patients suffered seven postoperative complications: three cases of wound disruption, one surgical site infection, one urinary tract infection, one case of bleeding, and one of systemic sepsis. Ultimately, all patients were discharged home following surgery, after an average length of stay of 3.94 days (SD = 1.85).

Conclusion:

This study contributes to the body of knowledge surrounding pediatric diastematomyelia, a rare condition for which management and outcomes have not been adequately studied to date. The limited scope of this study also highlights the need for improved coding and tracking of this condition, and further similar studies are warranted to continue classifying this patient population.