Diastematomyelia, evaluation and treatment: A multi-center perspective and review of literature

Abstract

Introduction: Diastemamtomyelia is a rare congenital disorder, caused by longitudinal duplication of the spinal cord. Some patients are asymptomatic at birth, leading to delayed diagnosis. The average age of the patients at the time of diagnosis is 5–7.4 years. Adults constitute around 20% of diagnosed cases, with an average age of 37.8 at the time of diagnosis. Early diagnosis and appropriate treatment can prevent neurological complications. Methods: This retrospective study covers all patients with the primary diagnosis of diastematomyelia at three tertiary referral hospitals in Iran between April 1996 and December 2022. Patients who were followed up for less than a year after surgery and the ones who underwent surgery due to accompanying lesions such as myelomeningocele, were excluded from the study. All patients were operated on using microscopic or loup magnification. Results: This retrospective study included thirty patients diagnosed with diastematomyelia. The mean age of patients was 20.4 years old ranging from 8 months to 63 years old. Eighteen of patients were below 18 and twelve were older than 18 years old, with the mean age of 10.1 and 36 years old, respectively. Six (20 %) of the patients were male, and 24 (80 %) were female, with a gender ratio of 1/4 (M/F). For patients younger than 18 years old, 3 (16.7 %) were boys and 15 (83.3 %) were girls (M/F: 1/5). Within the subgroup of patients older than 18, 3 (25 %) were male and 9 (75 %) were female (M/F: 1/3). Conclusion: Early diagnosis and treatment of diastematomyelia can prevent neurological irreversible complications.

Keywords

• Split cord
• Occult spinal dysraphism
• Diastematomyelia