Diastematomyelia

Diastematomyelia: Description, Causes and Risk Factors: Complete or incomplete sagittal division of the spinal cord by an osseous or fibrocartilaginous septum. DiastematomyeliaDiastematomyelia is a congenital disorder in which a part of the spinal cord is split, usually at the level of the upper lumbar vertebra. Females are affected much more commonly than males. This condition occurs in the presence of an osseous (bone), cartilaginous or fibrous septum in the central portion of the spinal canal which then produces a complete or incomplete sagittal division of the spinal cord into two hemicords. When the split does not reunite distally to the spur, the condition is referred to as a Diplomyelia, or true duplication of the spinal cord. Diastematomyelia is classified as type 1 (two dural tubes — diastematomyelia) and type 2 (one dural tube — diplomyelia). It is a complex defect which occurs during the 4th week of fetal development. Diastematomyelia is a rare form of spinal dysraphism which occurs as a result of the foetus having an accessory neurenteric canal. This canal lies in the midline and therefore the developing spinal elements (vertebrae, dural tube, spinal cord and spinal nerves) are separated (split) and develop as two sets of structures. These are separated by the mesenchymal components in the midline, being combinations of bone (the spur), cartilage and fibrous tissue. There is always a sagittal cleft of varying extent, with a “split” spinal cord, and the hemicords are more often of equal size but may be asymmetrical with musculature on the leg on the side of the smaller hemicord being typically of lesser diameter. The cords re-unite a variable distance cephalad to the spur or tethering lesion, and it is here that the problem of tethering occurs. In type 1 each of the two dural sacs is occupied by a hemicord, and the residual mesenchymal elements include a bony spur which lies between the dural tubes. It is this rigid spur that prevents normal spinal cord mobility, and movement with growth and physical activity will usually render the patient symptomatic. In type 2 the tethering lesion is a thick fibrous band (called a myelomeningocele manqu

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