Prenatal diagnosis of diastematomyelia: A case report and review of the literature

Abstract

Diastematomyelia is a rare congenital disorder in which the spinal cord is divided longitudinally for part of its length. It can be accurately identified in the prenatal period by detailed sonographic examination of the spine. We report a case of diastematomyelia localized to spinal levels T6-T9 diagnosed prenatally at 31 weeks' gestation and review the existing literature on the diagnosis and management of this condition during pregnancy.

The Value of Prenatal Ultrasonographic Diagnosis of Diastematomyelia

“…Ultrasonic waves can pass through the spinal canal as a result of incomplete ossification of the fetal spinous lamina, and detect the structure of the spine; thus, they can be used as a method for the early diagnosis of spinal and spinal cord deformities. Since Williams first diagnosed diastematomyelia using ultrasonography in 1985, a total of 44 cases of diastematomyelia have been successfully diagnosed with prenatal ultrasonography, including the four cases reported in the present study. We conducted a retrospective analysis of all 44 cases, and the clinical characteristics can be summarized as follows: Gravidas with diastematomyelia diagnosed prenatally were between the ages of 18 and 40 (mean age, 27.0 ± 5.4 years); the diagnosis of diastematomyelia was confirmed at a gestational age of 13 to 36 weeks (average, 21.8 ± 5.5 weeks); of the 44 cases, 19 (43.2%) occurred at the lumbar level, followed by 11 at the thoracolumbar level (25.0%), 10 at the thoracic level (22.7%), 3 involving the thoracic and lumbar spine (6.8%), and 1 at the sacral spine (2.3%); 27 of 35 cases (77.1%) were categorized as type I diastematomyelia, and 9 of 35 (22.9%) were type II diastematomyelia; and 9 of 44 gravidas (20.5%) were on medications during pregnancy.…”

Rutin ikinci trimester sonografisinde diastematomiyelinin teşhisi

“…Çoğu olguda, lezyonlar, omurganın alt torasik ve üst lomber kısımlarında bulunur (5). Ek olarak, diastematomiyeli'nin kız fetüslarda daha sık gözlendiği rapor edilmiştir (6).…”

“…Diastematomiyelinin sonografik özellikleri arasında, koronal düzlemde spinal kanalın genişlemesi ile aksiyal planda anterior ve posterior duvarlar arasındaki spinal kanal ve etkilenen spinal segmenti örten sağlam deri ve yumuşak dokular arasında geçiş yapan ek bir ekojenik odak yer alır (5,6). Diastematomiyeli ayırıcı tanısında izole meningosel, intraspinal lipom ve diğer kapalı disrafizm tipleri yer alır (7).…”

Prenatal diagnosis and clinicopathologic examination of a case with diastematomyelia

“…Diastematomyelia is a rare form of occult spinal dysraphism that occurs as a result of abnormal development of the notochord in early days of intrauterine development (Li et al. ). It is characterized by longitudinal clefting, formation of two hemicords and enlargement of the spinal canal.…”