0:01

This is a child that had spastic gait and

0:04

was known to have spinal dysraphism.

0:07

As we look at the T1-weighted scan, we would calculate

0:09

that the cord ends at approximately the L4 level,

0:14

therefore is low in location.

0:16

We also see that the patient has a syrinx in

0:19

the spinal cord at the L1-T12 level.

0:23

And this is well demonstrated on the T2-weighted sequences.

0:27

However,

0:27

at the level of the spinal dysraphism you see

0:30

that the spinous processes are missing

0:32

here. We see this little bony bar which is extending

0:36

to a fused L4 and L5 vertebral body segment.

0:41

So this patient has a segmentation anomaly.

0:44

A low spinal cord or tethered cord, has a syrinx.

0:47

And then when we look at the axial scan, we see that there is

0:51

a separation of two thecal sacs with this bony bar

0:56

at the L4-L5 level, and then it reconnects

1:00

to a low-lying conus, down at the L5-S1 level.

1:05

So this is L5-S1.

1:07

We scroll superiorly.

1:09

We have the two portions of the cord separating by this

1:13

diastematomyelia. And then as we go higher, they will fuse back,

1:19

you see, into a single spinal cord with a syrinx.

1:23

So this is an excellent

1:25

example of all the potential associations of

1:28

diastematomyelia. That is, it may have a syrinx,

1:32

it may have a spinal dysraphism,

1:34

it may have a tethered cord.

1:36

And in this case,

1:37

it's a separation by bone with the

1:40

two hemicords coming together.

1:43

Remember that each of these hemicords has just

1:47

one side's nerve roots. So here's the left side.

1:50

You don't see any nerve roots coming

1:51

off of the right side of this hemicord.

1:53

And you don't see any nerve roots coming

1:55

off of the left side of this right hemicord.

1:57

And then they combine together more inferiorly

2:00

into the tethered cord. A wonderful case.

2:04

And that's why I love diastematomyelia,

2:06

in addition to the fact that it's

2:08

approximately nine syllables.