Trifid Cord; Very Rare Presentation of Split Cord Malformation

A child with a very rare anomaly of spinal cord is described. The patient presented at 9 months of age with trifid cord at thoracolumbar region and extensive split cord malformation (SCM) from T12-L5. She had a composite type SCM including type II at T12-L1 and SCM type I from L2, L3, to L4 levels. The condition seemed to be something like three distinct cords at T12-L1 level composed of a thin cord at left side terminating before L2 level to a tiny fibrous band, and two thick middle and right cords which joined together at conus at L5 level. The patient had a large hairy patch on her back with asymmetric legs without any movements in her smaller foot. Cord untethering and removing the bony ridge causing SCM were performed with laminectomy of L2 to L5 and laminotomy of T12 and L1, Her neurological status was unchanged after surgery and remained stable during 6 month follow up.