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Type II split cord malformation

Case contributed by Hidayatullah Hamidi
Diagnosis certain

Presentation

Sciatica, lower limb weakness.

Patient Data

Age: 10 years
Gender: Male

Conus medullaris terminates at L5 level (low position), likely attached to the posterior wall of the spinal canal.
Split cord at L1-L2 levels.
No discreet bony spur is seen in the spinal canal in the MRI images.
Ankylosis of the spinal processes of L2-L3, accompanied by intervertebral disc thinning at this level. Consider CT scan.
Cystic structures in the sacral canal (S2-S4 levels), abutting and scalloping the sacral vertebrae - most probably Tarlov cysts.

Case Discussion

The features represent split cord malformation; more precisely, diastematomyelia type II.

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