Presentation
The patient, a second gravida, presented for a regular antenatal care work-up.
Patient Data
There is increased interpedicular distance seen at the fetal thoraco-lumbar vertebral level, with a bony spur within the spinal cavity. The overlying skin appears intact, with no evidence of herniation or mass lesion.
Case Discussion
Diastematomyelia is characterised by the spinal cord being split into two hemicords, each enclosed in its own dural sac, often by a bony or fibrous septum. The ultrasound typically shows the echogenic bony spur causing the division of the spinal cord. This condition can be diagnosed prenatally, and the bony spur is often identified as a hyperechoic structure within the spinal canal. The presence of a closed defect indicates that the overlying skin is intact, differentiating it from open forms of spina bifida. Early detection through detailed ultrasound is crucial for planning postnatal management and potential surgical intervention to prevent further neurological damage and to optimise outcomes.
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