Forme rare du dysraphisme spinal fermé: la diastématomyélie: A rare form of closed spinal dysraphism: diastematomyelia

Diastematomyelia is a rare spinal dysraphism in which the spinal cord and its content are split. Two types of diastematomyelia have been described. We report the case of a 12 year old male patient presenting with reduced lower limb muscle strength without associated sphincteric disorders. The patient underwent axial, sagittal and coronal T1 and T2-weighted MRI sequence of the spine. MRI showed a bifid appearance of the bone marrow of thoracolumbar vertebrae in two hemi-cords without bone spur separating the two hemi-marrows, compatible with type 1 diastematomyelia. It was associated with low tethered spinal cord with syringomyelic cavity involving the left hemi-marrow and with biloculated fibrotic lesion at the level of the right hemi-marrow compatible with a neuroenteric cyst. MRI also showed incomplete closure of the posterior arch of D12 vertebra which communicated with a subcutaneous pocket in relation to a dermal sinus. Diastematomyelia is a rare abnormality of the spine which can be associated with other malformations. Therapeutic strategy essentially depends on the progression of the clinical signs (neurological) and of associated malformations.