Radiology Teaching Files > Case 6901960

previously visited DIASTEMATOMYELIA
Contributed by: Alex Tornow, Resident, Virginia Mason Medical Center, Washington, USA.
Patient: 52 year old female
History: 52F presents with upper abdominal pain and lower rib pain of unknown etiology.

Fig. 1: L1 axial CT image.
Findings: Midsaggital osseous septum through the spinal canal at L1.
Diagnosis: diastematomyelia

Case conclusion:

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 discussion:

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.

References:  YC Gan et al., Diastematomyelia in children: treatment outcome and natural history of associated syringomyelia. Childs Nerv Syst. 2006 Oct 7.
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Additional Details:

Case Number: 6901960Last Updated: 10-10-2006
Anatomy: Spine and Peripheral Nervous System   Pathology: Congenital
Modality: CTAccess Level: Readable by all users

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