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Utility of 3D-T2 space MRI sequence in diagnosing a rare cause of lower backache: horseshoe cord and meningocoele manqué in a case of composite split cord malformation
  1. Sanjay Khaladkar1,
  2. Pranav Ajmera1 and
  3. Snehal Rathi2
  1. 1Radiology, Dr D Y Patil Medical College Hospital and Research Centre, Pune, Maharashtra, India
  2. 2Radiology, Mahatma Gandhi Mission's Institute of Health Sciences, Navi Mumbai, Maharashtra, India
  1. Correspondence to Dr Pranav Ajmera; pranavajmera{at}


Diastematomyelia is the asymmetric or symmetric lateral duplication of the spinal cord into two hemicords. Pang divided it into three types: type-1, type-2 and composite split cord malformation (SCM). Composite SCMs are uncommon and are defined by the coexistence of multiple types of split cord with normal cord in between. When partially bridged, they are called a horseshoe cord. We report a case of a young woman who presented with backache and was diagnosed with composite SCM with horseshoe cord and type-2 SCM with intervening normal cord. In our case, 3D-SPACE due to its superior topographical evaluation, allowed us to visualise and characterise the thin meningocoele manque bands and detect horseshoe cords, asymmetric cords and demarcate the precise extent of syrinx, which were suboptimally imaged on isolated T2 and T1WI sequences. If left untreated during surgery, bands can be the potential cause for persistent backache.

  • Radiology
  • Neuroimaging
  • Spinal cord
  • General practice / family medicine

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  • Contributors SMK: First made the diagnosis, conceived the idea, methodology, involved in drafting the original manuscript, reviewing and overall supervision. PA: Performed investigation (followed-up the case), involved in drafting the original manuscript, reviewing, methodology, visualisation of the outline and conception of the diagrams and flowchart. SR: Involved in reviewing and editing the manuscript, conception of the diagrams and flowchart.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.