Split spinal cord malformation in an elderly patient: Case report

Alfredo Quinones-Hinojosa, Chirag A. Gadkary, Praveen V. Mummaneni, William S. Rosenberg

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Split spinal cord malformations (SCM) typically present in childhood and rarely in adulthood. Very little is known about the SCMs in the elderly, and the diagnosis can be easily missed. CASE DESCRIPTION: A 73-year-old woman with a childhood history of scoliosis and late ambulation milestones presented with a 2-year history of worsening low back pain and progressive difficulty walking. She had a mild gait disturbance with 4/5 weakness in left ankle dorsiflexion. Magnetic resonance imaging revealed a bifid spinal cord contained in a single thecal sac and a tethered cord with low-lying conus at L3. The patient was taken to the operating room and a soft-tissue median septum, as well as all other adhesions, was removed. The filum terminale was identified, coagulated, and divided. Six weeks later, the patient reported decreased back pain, improvement in ambulation, and markedly decreased used of narcotics for her back and leg pain. Her left ankle dorsiflexion strength improved to 4+/5. CONCLUSION: This patient had two hemicords encased in a single dural tube separated by a nonrigid, fibrous median septum and an associated tethered cord. Adult presentation of SCM is extremely rare. This case highlights the need to consider split cord malformation and tethered cord in the differential diagnosis not only for adults but also the elderly presenting with back pain, scoliosis, and difficulty walking.

Original languageEnglish (US)
Pages (from-to)201-203
Number of pages3
JournalSurgical Neurology
Volume61
Issue number2
DOIs
StatePublished - Feb 2004
Externally publishedYes

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Back Pain
Mobility Limitation
Spinal Cord
Scoliosis
Ankle
Walking
Cauda Equina
Narcotics
Operating Rooms
Low Back Pain
Gait
Leg
Differential Diagnosis
Magnetic Resonance Imaging

Keywords

  • Diastematomyelia
  • Diplomyelia
  • Double spinal cord malformation
  • Split cord malformation

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Quinones-Hinojosa, A., Gadkary, C. A., Mummaneni, P. V., & Rosenberg, W. S. (2004). Split spinal cord malformation in an elderly patient: Case report. Surgical Neurology, 61(2), 201-203. https://doi.org/10.1016/S0090-3019(03)00431-2

Split spinal cord malformation in an elderly patient : Case report. / Quinones-Hinojosa, Alfredo; Gadkary, Chirag A.; Mummaneni, Praveen V.; Rosenberg, William S.

In: Surgical Neurology, Vol. 61, No. 2, 02.2004, p. 201-203.

Research output: Contribution to journalArticle

Quinones-Hinojosa, A, Gadkary, CA, Mummaneni, PV & Rosenberg, WS 2004, 'Split spinal cord malformation in an elderly patient: Case report', Surgical Neurology, vol. 61, no. 2, pp. 201-203. https://doi.org/10.1016/S0090-3019(03)00431-2
Quinones-Hinojosa A, Gadkary CA, Mummaneni PV, Rosenberg WS. Split spinal cord malformation in an elderly patient: Case report. Surgical Neurology. 2004 Feb;61(2):201-203. https://doi.org/10.1016/S0090-3019(03)00431-2
Quinones-Hinojosa, Alfredo ; Gadkary, Chirag A. ; Mummaneni, Praveen V. ; Rosenberg, William S. / Split spinal cord malformation in an elderly patient : Case report. In: Surgical Neurology. 2004 ; Vol. 61, No. 2. pp. 201-203.
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