Presentation
Spine deformity.
Patient Data
The MRI sequences demonstrate:
marked thoracolumbar spine scoliosis
conus medullaris terminates in a low position at S1 (tethered cord syndrome)
long segment diastematomyelia starts from D5 down to L3 vertebrae levels
hemicords separated by a bony spur at L1/2 level (diastematomyelia type I )
vertebral abnormalities: butterfly vertebrae of L1
dural ectasia at the thoracolumbar region
Case Discussion
MRI features of diastematomyelia, also known as a split cord malformation type I which is the classic type and characterised by:
duplicated dural sac with midline spur (osseous or osteocartilaginous)
hydromyelia is common
vertebral abnormalities such as hemivertebrae, butterfly vertebrae, spina bifida
cutaneous pigmentation, hypertrichosis, haemangioma are common
patients are usually symptomatic presenting with scoliosis and tethered cord syndrome
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