Diastematomyelia - Symptoms, Reasons And Treatment

Diastematomyelia is a rare condition where the spinal cord is split into two parts, usually occurring in the lower back area. This happens when the spinal cord doesn't form properly during fetal development. The split can be caused by a piece of bony or cartilaginous tissue within the spinal canal that divides the cord into two parts.

This abnormality can put pressure on the spinal cord and affect its function. Although diastematomyelia is not common, it can lead to various complications if left untreated. If you or a loved one has been diagnosed with diastematomyelia, it's essential to seek guidance from a healthcare provider to understand the condition better and explore appropriate management options.

What Are the Symptoms of Diastematomyelia

Diastematomyelia is a condition where the spinal cord is split into two parts, causing various symptoms. Common signs include back pain, weakness or numbness in the legs, difficulty walking, and abnormalities in the curvature of the spine. Some individuals may also experience bladder or bowel problems due to the spinal cord's abnormal development. If you or someone you know is experiencing these symptoms, it's important to seek medical attention for proper diagnosis and treatment.

Diastematomyelia can present with back pain, especially in the lower back region, due to the spinal cord abnormality.
Neurological deficits such as weakness or numbness in the legs can occur as a result of diastematomyelia.
Some individuals with diastematomyelia may experience bladder or bowel dysfunction, leading to issues with urinary or fecal incontinence.
Scoliosis, a sideways curvature of the spine, may develop in individuals with diastematomyelia as a secondary symptom.
Diastematomyelia can sometimes manifest with foot deformities or abnormalities in the lower extremities due to nerve compression.

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Causes of Diastematomyelia

The main factors contributing to diastematomyelia involve the incomplete separation of the spinal cord into two distinct hemi-cords, leading to the formation of a bony or fibrous septum within the spinal canal. This division can cause the spinal cord to be split into two parts, potentially leading to neurological complications and symptoms such as back pain, weakness, and sensory abnormalities. While the exact cause of diastematomyelia remains unclear, genetic predisposition and environmental factors may play a role in its development.

Genetic factors can predispose individuals to developing diastematomyelia.
Certain developmental abnormalities during embryonic growth may lead to the formation of diastematomyelia.
Traumatic injuries, such as spinal cord trauma, can cause diastematomyelia.
Infections like meningitis or other inflammatory conditions can contribute to the development of diastematomyelia.
Tumors in the spinal cord or surrounding tissues can result in diastematomyelia.

Types of Diastematomyelia

The two main types of diastematomyelia are complete and incomplete. In complete diastematomyelia, the spinal cord is completely divided into two distinct parts, each contained within its own dural sac. In incomplete diastematomyelia, there is a partial division of the spinal cord, with the two segments often sharing a single dural sac. This condition can lead to various neurological symptoms and requires surgical intervention in some cases.

Complete Diastematomyelia: In this type, the spinal cord is completely divided into two separate parts.
Incomplete Diastematomyelia: Here, the spinal cord is only partially divided into two sections.
Type I Diastematomyelia: This type involves a fibrous or bony septum dividing the spinal cord.
Type II Diastematomyelia: In this type, the spinal cord is split into two hemicords without a bony or fibrous septum.
Type III Diastematomyelia: It is characterized by one hemicord being normal while the other is syrinx-filled.

Risk Factors

Diastematomyelia, a rare congenital disorder where the spinal cord splits into two parts, can be influenced by various risk factors. These factors may include genetic predisposition, maternal exposure to certain toxins or infections during pregnancy, inadequate prenatal care, and certain underlying conditions such as spina bifida. Additionally, environmental factors and maternal age at conception may also play a role in the development of diastematomyelia. Understanding these risk factors is crucial in the prevention and management of this condition.

Genetic predisposition: Individuals with a family history of spinal cord abnormalities may have an increased risk of developing diastematomyelia.
Female gender: Diastematomyelia is more commonly seen in females compared to males, suggesting a potential gender-related risk factor.
Environmental factors: Exposure to certain environmental factors during fetal development may contribute to the development of diastematomyelia.
Folic acid deficiency: Insufficient intake of folic acid during pregnancy has been linked to an elevated risk of neural tube defects, including diastematomyelia.
Maternal diabetes: Women with poorly controlled diabetes during pregnancy may have a higher likelihood of giving birth to a child with diastematomyelia.

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Diagnosis of Diastematomyelia

During the clinical evaluation, a healthcare provider will review the patient's medical history, conduct a physical examination, and assess neurological function. Imaging studies, such as MRI scans, are crucial in visualizing the spinal cord and identifying the presence of a division or cleft within it. In some cases, electromyography (EMG) or nerve conduction studies may be performed to evaluate nerve function. The combination of these diagnostic approaches helps in accurately identifying diastematomyelia and planning appropriate treatment.

Diastematomyelia can be diagnosed through imaging tests such as MRI or CT scans to visualize the spinal cord.
Clinical assessment by a healthcare provider involves evaluating symptoms, conducting physical examinations, and taking a detailed medical history.
Electromyography (EMG) may be used to assess nerve function and muscle activity in individuals with suspected diastematomyelia.
Neurological testing, including sensory and motor function assessments, can help in diagnosing diastematomyelia.
Genetic testing may be recommended in some cases to identify underlying genetic conditions associated with diastematomyelia.

Treatment for Diastematomyelia

Treatment options may include decompression of the spinal cord to relieve pressure, detethering of the spinal cord to address any tethered cord syndrome, and the removal of any bony or fibrous septum causing the division. Physical therapy and rehabilitation may also be recommended to aid in postoperative recovery and improve overall function. The specific treatment approach will depend on the individual patient's symptoms, the extent of spinal cord involvement, and other contributing factors, with the goal of optimizing neurological function and quality of life.

Treatment for diastematomyelia depends on symptom severity and aims to relieve symptoms, prevent progression, and improve quality of life.
Conservative management with regular monitoring and physical therapy may be suitable for mild symptoms.
Surgical intervention may be needed in severe cases where symptoms persist or worsen.
Surgery may involve detethering the spinal cord, removing bony abnormalities, and addressing related conditions like tethered cord syndrome.
Neurosurgical procedures are typically performed by specialists experienced in complex spinal cord malformations.
Post-surgical care is essential for recovery and to maximize functional outcomes.

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