title: Split cord malformation with diastematomyelia presenting as neurogenic claudication in an adult: a case report.
abstract: METHODS
  This is a report of a rare presentation of a split cord malformation with diastometamyelia.
  
  
  OBJECTIVE
  This report draws attention to the fact that the only manifestation of diastmetamyelia in the adult patient may be neurogenic claudication.
  
  
  BACKGROUND
  Patients with split cord malformations and diastometamyelia rarely have symptomatic onset in adulthood. When present, a traumatic event leading to an acute neurologic change is the usual presentation.
  
  
  METHODS
  An adult patient presented with symptoms of neurogenic claudication in the left leg. Magnetic resonance imaging examination showed a split cord malformation and diastometamylia at L3-L4 with spinal stenosis of the left hemicord. Decompressive laminectomy and subtotal resection of the bony spur were performed.
  
  
  RESULTS
  Two years after decompression, the patient has complete resolution of his leg symptoms and is back to work.
  
  
  CONCLUSIONS
  Neurogenic claudication without any objective neurologic deficit or neurocutaneous stigmas of an underlying spinal cord abnormality may be the only presentation in the adult with diastometamyelia. Decompression to relieve both clinical and radiologic evidence of spinal stenosis obtained excellent outcome.
authors.affiliation: Department of Surgery, University of Toronto, Ontario, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Kaminker
authors.forename: J
authors.initials: J
authors.lastname: Fabry
authors.forename: R
authors.initials: R
authors.lastname: Midha
authors.forename: J A
authors.initials: JA
authors.lastname: Finkelstein
mesh_terms: D000328:Adult; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D009436:Neural Tube Defects / Q000150:complications* / Q000473:pathology / Q000601:surgery; D013116:Spinal Cord / Q000002:abnormalities* / Q000473:pathology / Q000601:surgery; D016135:Spinal Dysraphism / Q000150:complications* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome