Split cord malformation with diastematomyelia presenting as neurogenic claudication in an adult - A case report

Study Design. This is a report of a rare presentation of a split cord malfo rmation with diastometamyelia. Objectives. This report draws attention to the fact that the only manifesta tion of diastmetamyelia in the adult patient may be neurogenic claudication . Summary of Background Data. Patients with split cord malformations and dias tometamyelia rarely have symptomatic onset in adulthood. When present, a tr aumatic event leading to an acute neurologic change is the usual presentati on. Methods. An adult patient presented with symptoms of neurogenic claudicatio n in the left leg. Magnetic resonance imaging examination showed a split co rd malformation and diastometamylia at L3-L4 with spinal stenosis of the le ft hemicord. Decompressive laminectomy and subtotal resection of the bony s pur were performed. Results. Two years after decompression, the patient has complete resolution of his leg symptoms and is back Conclusions. Neurogenic claudication without any objective neurologic defic it or neurocutaneous stigmas of an underlying spinal cord abnormality may b e the only presentation in the adult with diastometamyelia. Decompression t o relieve both clinical and radiologic evidence of spinal stenosis obtained excellent outcome.