| Discussion: |
This patient's L1 diastematomyelia was likely an incidental finding unrelated to the patient's pain. However, the patient did have degenerative disk disease and facet joint DJD at L1-L2, which was likely related to poor facet joint alignment below the affected L1 vertebra.
Diastematomyelia is a rare congenital malformation in which an osseous, fibrous, or cartilagenous septum divides the spinal canal in the midsagittal plane. The spinal cord generally divides into hemicords at that level. The condition is associated with tethered cord, syringomyelia, and spina bifida occulta. The associated abnormalities often to lead to presentation in early childhood. Many of these patients have neurological defecits, but it is unclear to what extent this is due to diastematomyelia versus associated neurogical malformations. With recent increases in CT imaging, it is becoming a more common incidental finding in asymptomatic adults.
Excision of the septum in infancy may have neurologic benefits in symptomatic patients.