Split cord types I and II in a female patient with clinical onset in adulthood and further remission of symptoms

Split cord malformations (SCMs) constitute a relatively uncommon type of occult spinal dysraphism, characterized by the presence of a septum within the spinal canal, dividing the spinal cord into two separate hemicords. The septum can be bony, with the hemicords retained within two separate dural sacs (SCM type I), or fibro-cartilaginous, with the presence of one dural sac containing both hemicords (SCM type II). Its clinical findings are much more common in childhood than in adulthood, and vary according to the age of the patient at onset. This is a case of a 46 year old woman who underwent Harrington rod spinal fusion at the age of 12 for thoracolumbar left-convex scoliosis. She did not have of any neurological disturbance until the age of 46, when she started to complain of low back pain together with weakness of lower limbs and bladder dysfunction. The neuroradiological findings were consistent with split cord malformation of both types (I and II). The patient was discharged because of partial remission of motor weakness and cessation of urinary symptoms, with an indication for periodical clinical follow-up.