Miscellaneous conditions

Diastomatomyelia

Diastomatomyelia is a congenital condition characterized by a fibrous or osseous bar that causes a longitudinal split in the spinal cord, often within the lumbar spine. This split causes the spinal cord to reconfigure below the point of division, which may lead to tethering of the cord. It is frequently associated with unusual forms of scoliosis and kyphosis, such as infantile and congenital scoliosis.

Diagnostic Imaging:

- X-Ray: May show interpedicular widening.

- MRI: Provides confirmation and a detailed view of the split.

Management: - Before correcting any associated spinal deformity, excision of the bar is recommended if it poses a risk. However, if the patient is asymptomatic, the bar can be left in place.

Sacral Agenesis

Sacral agenesis is defined by the absence of the sacrum and parts of the lower lumbar spine. This condition is linked to maternal diabetes and is often associated with a prominent lumbar spine. Affected children typically adopt a “Buddha” sitting position due to the altered spine structure.

Management Options:

1. Amputation

2. Spinal-pelvic fusion