Split cord malformation

Case Summary ; 

This 55 year old lady presented with chronic low back pain for 25 years with bilateral lower limb paresthesia for 2 years associated with stress incontinence and urgency of micturition for the past few months. She was ambulant independently and had no features of neurogenic claudication. MRI showed L5-S1 grade 2 listhesis, type 2 thoracolumbar SCM and low lying conus with fatty filum terminale. There was no root compression at level to listhesis and as her neurological symptoms could be explained by the fatty filum terminale, it was decided to operate on this at present and not to intervene for the grade 2 listhesis.