45 year-old with longstanding bowel and bladder incontinence

---

Findings:

Split cord with a single thecal sac. Low lying spinal cord at L3-4 Abnormal sacral morphology Widened lower lumbar spine thecal sac with absent posterior elements.

DDX:

Diastematomyelia type 1, type 2

---

Diagnosis:

Diastematomyelia type 1

Discussion:

Diastematomyelia type 1 is associated with sacral anomalies and a low lying and likely tethered spinal cord. This patient is status post prior lumbar spine surgery

---

Submitted by Jeff Pugsley, MD, UW Radiology Resident