General Spine

Bruno A Policeni, MD, Non ASSR Member
Wendy R.K. Smoker, MD FACR, ASSR Member
Toshio Moritani, MD PhD, Non ASSR Member

Excerpta Extraordinaire

Excerpta

Diastematomyelia is a rare form of spinal dysraphism characterized by the presence of an osseous, cartilaginous, or fibrous septum that sagittally clefts the spinal cord and/or filum terminale into two hemicords. The partitioning may be complete or incomplete and, although it may be an isolated finding, diastematomyelia is often associated with vertebral segmentation anomalies.

We present a case of three-level (triple) diastematomyelia in a 3 year-old boy demonstrated on plain radiographs, CT with 3D reconstructions, and MRI. The highest level was a partial osseous cleft at T6, the middle level was a large complete osseous cleft extending from T8 to T10 associated with vertebral segmentation anomalies, and the lowest level was also completely osseous at L3-4. The cord was tethered, divided over a long segment. In addition, multiple other congenital spinal anomalies were present.

To our knowledge, triple diastematomyelia has not been previously reported in the English literature. In a paper by McClelland et al (Radiology, 1977), mention of such a case by personal communication was made but not documented. Our review indicates that seven cases of two-level (double) diastematomyelia have been previously described.