Diastematomyelia: Overview, Causes, Symptoms, and Treatment
Diastematomyelia is a rare congenital neurological condition in which the spinal cord is split into two hemicords, usually by a bony, cartilaginous, or fibrous septum. This condition falls under the broader group of spinal dysraphisms and is often detected in childhood, though some mild cases may remain undiagnosed until adulthood.
What is Diastematomyelia?
Diastematomyelia is a developmental abnormality of the spinal cord where a longitudinal cleft divides the cord into two separate parts. Each hemicord may have its own nerve roots and covering membranes. The split typically occurs in the thoracic or lumbar regions of the spine and can vary in severity.
This condition is closely associated with other spinal anomalies such as scoliosis, spina bifida, and tethered cord syndrome.
Causes and Risk Factors
The exact cause of diastematomyelia is not fully understood, but it is believed to occur during early fetal development due to abnormal splitting of the notochord or neural tube. Genetic and environmental factors may contribute, although no single cause has been definitively identified.
In many cases, it is part of a spectrum of congenital spinal malformations rather than an isolated defect.
Symptoms
Symptoms of diastematomyelia vary depending on the severity of the spinal cord split and the presence of associated abnormalities. Some individuals may remain asymptomatic for years, while others experience progressive neurological issues.
Common symptoms include:
Back pain, especially in the lower spine
Weakness or stiffness in the legs
Abnormal gait or difficulty walking
Unequal leg length or foot deformities
Sensory loss or numbness
Bowel or bladder dysfunction in severe cases
Visible skin markers such as dimples, tufts of hair, or fatty masses over the spine
Diagnosis
Diastematomyelia is primarily diagnosed using imaging techniques. Magnetic Resonance Imaging (MRI) is the most effective tool for visualizing the split spinal cord and associated anomalies. CT scans may also help identify bony septum formation.