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Tuesday, January 27, 2015
Spine and Back Health
I recently got the results of my MRI and was diagnosed with diastomatomyelia the dysaphism involving the dorsal elements of L5 and S1 with associated spinal cord tethering and diastomatomyella(split cord) from the L1 to upper L3 level. There is a septum at the S1 level which may be fibrous or osseous. Below the level of the septum, there is a large sacral cyst causing bony expansion as descibed. It is likely a menigneal cyst such as an arachoid cyst or an isolated portion of the thecal sac. I would like to know if it is possible to have surgery to remove this cyst as it is causing me alot of back pain. What procedure would you recommend?
Hello, thank you for your question. The abnormality you are describing, also known as a “split-cord malformation”, is extremely complicated and quite rare. The decision of whether to correct it surgically depends on a great number of factors. The surgery can become very complex, and carries a risk of major complications such as paralysis. However, in the hands of an experienced surgeon it can be done safely. These abnormalities are usually treated by pediatric neurosurgeons, since they are most commonly diagnosed in children. You don’t mention your age, but if you are an adult you might have to do some searching to find the right surgeon. I would recommend you start by seeing a pediatric neurosurgeon at a major academic children’s hospital for an evaluation. If you are going to have this fixed, you want someone who operates on these fairly often. Good luck.
David J Hart, MD
Associate Professor of Neurosurgery
School of Medicine
Case Western Reserve University