BACKGROUND Whether or not, prophylactic neurosurgical interventions of split cord malformation (SCM) before undertaking corrective surgery was the focus of debate. The present study was performed to evaluate the safety and efficacy of posterior-only surgical correction with heavy halo-femoral traction for the treatment of rigid congenital scoliosis (RCS) associated with SCM. METHODS From 2011 to 2017, 24 patients suffered from RCS associated with SCM underwent posterior-only surgical correction with heavy halo-femoral traction. The apex of the deformity was lumbar (n = 9), thoracic (n = 11), and thoracolumbar (n = 4). There were 13 cases of failure of segmentation; 4 cases of failure of formation and 7 cases of mixed defects. Based on SCM classification, there were 14 patients with SCM type 1 and 10 patients with SCM type 2. The Scoliosis Research Society (SRS)-22 and modified Japanese Orthopaedic Association (mJOA) scores were assessed preoperatively and at the final follow up. RESULTS The mean duration of surgery was 327.08 ± 43.99 min and the mean blood loss was 1303.33 ± 526.86 ml. The mean follow-up period was 20.75 ± 8.29 months. The preoperative mean coronal Cobb angle was 80.38° ± 13.55°; on the bending radiograph of the convex side, the mean Cobb angle was 68.91° ± 15.48°; the mean flexibility was 15.04% ± 7.11%. After heavy halo-femoral traction, the mean coronal Cobb angle was reduced to 56.89° ± 13.39°. After posterior-only surgical correction, postoperative mean coronal Cobb angle was further reduced to 32.54° ±11.33°. The postoperative mean correction rate was 60.51% ± 7.79%. At the final follow up, the corrective loss rate of Cobb angle was only 3.17%. The SRS-22 total score improved at the final follow-up evaluation compared with the preoperative SRS-22 total score. The spinal cord function was stable and there were no new neurological symptoms after correction. There were no significant differences between final follow-up and preoperative mJOA total scores. CONCLUSIONS Without prophylactic neurosurgical intervention and spine-shortening osteotomy, posterior-only surgical correction with heavy halo-femoral traction could be safe and effective for the treatment of RCS associated with SCM.

中文翻译：

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仅进行后路手术矫正并用重股-股骨牵引术治疗与裂痕畸形相关的刚性先天性脊柱侧弯。

背景技术在进行矫正手术之前是否进行裂神经畸形（SCM）的预防性神经外科手术干预一直是争论的焦点。进行本研究以评估仅采用后路股骨股牵引术的矫正术治疗伴有SCM的刚性先天性脊柱侧凸（RCS）的安全性和有效性。方法从2011年至2017年，对24例RCM伴有SCM的患者进行了仅后路手术治疗，并进行了严重的股骨股牵引。畸形的顶点是腰椎（n = 9），胸椎（n = 11）和胸腰椎（n = 4）。分割失败13例；形成失败4例，混合缺陷7例。根据SCM分类，有14例SCM 1型患者和10例SCM 2型患者。脊柱侧弯研究学会（SRS）-22和改良的日本骨科协会（mJOA）评分在术前和最终随访时进行评估。结果平均手术时间为327.08±43.99分钟，平均失血量为1303.33±526.86 ml。平均随访时间为20.75±8.29个月。术前平均冠状Cobb角为80.38°±13.55°；在凸面的弯曲射线照片上，平均科布角为68.91°±15.48°。平均柔韧性为15.04％±7.11％。重度股股骨牵引后，平均冠状Cobb角减小至56.89°±13.39°。仅进行后路手术矫正后，术后平均冠状Cobb角进一步减小至32.54°±11.33°。术后平均矫正率为60.51％±7.79％。在最后的随访中，Cobb角的矫正丢失率仅为3.17％。与术前SRS-22总评分相比，SRS-22总评分在最终随访评估中有所改善。脊髓功能稳定，矫正后无新的神经系统症状。最终随访与术前mJOA总分之间无显着差异。结论如果没有预防性的神经外科手术干预和缩短脊柱截骨术，仅采用后路手术加重股-股骨牵引就可以安全有效地治疗伴有SCM的RCS。最终随访与术前mJOA总分之间无显着差异。结论如果没有预防性的神经外科手术干预和缩短脊柱截骨术，仅采用后路手术加重股-股骨牵引就可以安全有效地治疗伴有SCM的RCS。最终随访与术前mJOA总分之间无显着差异。结论如果没有预防性的神经外科手术干预和缩短脊柱截骨术，仅采用后路手术加重股-股骨牵拉可以安全有效地治疗伴有SCM的RCS。