Diastematomyelia - type I

Case contributed by Dr Ammar Haouimi

Presentation

Chronic low back pain with lumbar hypertrichosis.

Patient Data

Age: 18 years
Gender: Female
MRI

The MRI sequences demonstrate:

  • mild lumbar scoliosis of left-sided convexity
  • congenital vertebral block L2-L3
  • diastematomyelia type I at L2-L3 (hemicords separated by a bony spur)
  • the conus medullaris terminates at L2-L3 (normal anatomical variant)
  • hydromyelia at L1 level 
  • spina bifida oculta L4-S1

Case Discussion

MRI features of a diastematomyelia type I which is the classic form characterized by

  • usually symptomatic (scoliosis or signs of tethered cord syndrome)
  • duplicated dural sac/cord with midline spur (osseous or fibrous) 
  • hydromyelia common
  • vertebral abnormalities
  • skin pigmentation, hemangioma, and hypertrichosis (hair patch) are common

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