45 year-old with longstanding bowel and bladder incontinence





  
T2 sagittal and axial                                                                                                                                                         


   
T2 Coronal
                     

Findings:

Split cord with a single thecal sac.
Low lying spinal cord at L3-4
Abnormal sacral morphology
Widened lower lumbar spine thecal sac with absent posterior elements.


DDX:

Diastematomyelia type 1, type 2


Diagnosis:

Diastematomyelia type 1


Discussion:

Diastematomyelia type 1 is associated with  sacral anomalies and a low lying and likely tethered spinal cord.  This patient is status post prior lumbar spine surgery

Submitted by Jeff Pugsley, MD, UW Radiology  Resident

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