A Prospective Study of Cutaneous Manifestations of Spinal Dysraphism from India (original) (raw)
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Case Reports in Medicine, 2013
Occult spinal dysraphism is defined as a group of dystrophic conditions below an intact cover of dermis and epidermis. Ultrasonography using linear transducers is a fast, inexpensive, and effective method that makes it possible to view the content of the vertebral canal and bone structures. Magnetic resonance imaging (MRI) is reserved for elucidating the type of dysraphism and for planning corrective surgery. We present a case of a five-day-old female neonate who presented cutaneous stigmas (in the lumbar region, hands, and feet), in whom ultrasonography demonstrated dysraphism in the lumbar region. MRI confirmed the type of dysraphism and enabled surgical planning.
Spinal Dysraphisms: A New Anatomical–Clinicoradiological Classification
Indian Journal of Radiology and Imaging
Background Spinal dysraphisms refer to the congenital abnormalities of the spine and spinal cord due to aberrations in the processes of gastrulation, primary neurulation, and secondary neurulation. Embryology of many complex spinal dysraphisms are yet poorly understood and there is no agreeable anatomical–clinicoradiological classification with inclusion of recently documented and complex spinal dysraphisms. Aims and Objectives The main objective of this study was to review the imaging features of spinal dysraphisms with a better understanding of embryological abnormalities and propose a new classification inclusive of all complex and unusual dysraphisms based on anatomical and clinicoradiological correlation. Materials and Methods This was a retrospective single institutional observational study of 391 cases of spinal dysraphism for 10 years in our institution. Of 391 cases included in the study, 204 were males and 187 were females. Also, 123 cases belonged to the 0–6 months age gr...
Spinal Dysraphism of a Baby – A Case Report
BIRDEM Medical Journal, 2016
A 8 months old male child reported to paediatric OPD of Shaheed Suhrawardy Medical College Hospital with the complaints of small swelling in the back and tilting of body on one side during sitting and standing posture. His antenatal period was unremarkable, post natal period revealed delayed crying and immunization was not completed. Local examination showed a small hairy patch in lower dorsal region. General and systemic examination revealed no significant abnormality. Consulting physician advised to do X-ray of dorso-lumbar spine (both views), Ultrasonography (USG) of the swelling and FNAC from the swelling. X-ray report concluded as spinal dysraphism with widening of spinal canal. Ultrasonography showed dural ectasia. No malignant or granulomatous cells were found in FNAC. For confirmation of plain x-ray and USG findings, the patient's parent was advised to do MRI of dorsolumbar spine in Radiology and Imaging Department of BIRDEM hospital. MRI findings were compatible with Diastematomyelia with tethered cord as evidenced by two unequal hemicord separated by signal void cleft and low insertion of spinal cord at L4-L5 level. As MRI is less sensitive regarding bone , CT scan was done and CT revealed grossly abnormal vertebral bodies with an osseous spur traversing the entire canal dividing the canal into two halves. Spinal cord was also divided into two unequal cord. Considering X-ray, USG, CT and MRI, final Diagnosis was made as Type I Diastematomyelia with Tethered cord.
Importance of early radiologic diagnosis of congenital anomalies of the spine
Surgical Neurology, 1985
Tadmor R, Ravid M, Findler G, Sahar A. Importance of early radiologic diagnosis of congenital anomalies of the spine. Surg Neurol 1985;23:493-501. Manifest or occult spinal dysraphism in the absence of neurological symptoms is likely to remain undetected. Therefore, accurate and early diagnosis of such underlying anomalies is of prime importance for early surgical intervention in order to avoid late irreparable damage. During a period of just over 1 year, 17 such cases of spinal congenital anomalies were diagnosed by myelography with metrizamide and computed tomography-myelography. There were 16 cases of tethered cord, six with myelomeningocele, two with diastematomyelia, two with a split spinal cord, three with a lipoma, and the remaining three with vertebral anomalies. Scoliosis was present in 60%, weakness of both legs in 45%, and asymmetry of the feet in 25%. Some of these patients were initially brought to the orthopedic department for corrective surgery before undergoing a complete neurological evaluation; thus the radiologist was acting as the link between patient and neurosurgeon. Clinical experience has shown that surgical treatment can be successful and can thereby obviate further progression of neurological symptoms.
Spinal Dysraphism; Frequency of Rare Cases of Spinal Dysmorphism in View of Mri Findings
THE PROFESSIONAL MEDICAL JOURNAL, 2017
ORIGINAL PROF-3787 ABSTRACT… Introduction: MRI plays an important role in characterising spinal dysraphisms. The reason behind this is quality of MRI showing very high contrast resolution of soft tissues and the ability to detect fat in the lesion.T2 weighted images provide excellent contrast between the sub-arachnoid spaces and neural tissue while evaluating spinal dysraphisms. Objectives: To determine the frequency of rare disorders of spinal dysraphism in view of MRI findings of spinal dyspharism patients. Study Design: retrospective. Duration: the study was conducted from 1 st September 2015 to 30 th November 2015. Settings: Radiology department, Allied hospital Faisalabad. Methods: A total of 20 consecutive pediatric age group patients presented with clinical suspicion of spinal dysraphism were included. MRI L/S spine was carried out on 1.5Tesla Philips and diagnosis of various disorders of spinal dysraphism was made. Conclusion: MRI is the first choice examination for the detection of occult spinal dysraphism. Its timely diagnosis improving surgical & medical outcome as well as better & long term care of patients with spinal dysraphism. Majority of patients in the current study had tethered cord (75%), myelomeningocele (20%), myelocele (10%), lipomyelocele (10%) Dermal sinus tract (10%) & diastematomyelia (10%) followed by associated spinal lipomas (5%), caudal agenesis (5%) & anterior meningocele (5%).
Congenital spinal dermal tract: how accurate is clinical and radiological evaluation?
Journal of Neurosurgery: Pediatrics, 2015
OBJECT A dermal sinus tract is a common form of occult spinal dysraphism. The presumed etiology relates to a focal failure of disjunction resulting in a persistent adhesion between the neural and cutaneous ectoderm. Clinical and radiological features can appear innocuous, leading to delayed diagnosis and failure to appreciate the implications or extent of the abnormality. If it is left untreated, complications can include meningitis, spinal abscess, and inclusion cyst formation. The authors present their experience in 74 pediatric cases of spinal dermal tract in an attempt to identify which clinical and radiological factors are associated with an infective presentation and to assess the reliability of MRI in evaluating this entity. METHODS Consecutive cases of spinal dermal tract treated with resection between 1998 and 2010 were identified from the departmental surgical database. Demographics, clinical history, and radiological and operative findings were collected from the patient ...
The Professional Medical Journal
Introduction: MRI plays an important role in characterising spinal dysraphisms.The reason behind this is quality of MRI showing very high contrast resolution of soft tissuesand the ability to detect fat in the lesion.T2 weighted images provide excellent contrastbetween the sub-arachnoid spaces and neural tissue while evaluating spinal dysraphisms.Objectives: To determine the frequency of rare disorders of spinal dysraphism in view of MRIfindings of spinal dyspharism patients. Study Design: retrospective. Duration: the study wasconducted from 1st September 2015 to 30th November 2015. Settings: Radiology department,Allied hospital Faisalabad. Methods: A total of 20 consecutive pediatric age group patientspresented with clinical suspicion of spinal dysraphism were included. MRI L/S spine was carriedout on 1.5Tesla Philips and diagnosis of various disorders of spinal dysraphism was made.Conclusion: MRI is the first choice examination for the detection of occult spinal dysraphism.Its tim...
Spectrum of Spinal Dysraphism in Pediatric Patients in a Tertiary Care Hospital
Pakistan Journal Of Neurological Surgery, 2021
Objectives: To report the spectrum of spinal dysraphism presenting in pediatric patients admitted to the Department of Neurosurgery Lady reading hospital Peshawar. Material & Methods: A descriptive case series was conducted and total of 89 patients (age between 2 months to 12 years) were included who underwent the surgical treatment. All patients were examined for clinical and radiological diagnosis of spinal dysraphism. Results: The average age at treatment was 23 ± 39.77 months. The most recurring (52.8%) presenting symptom was the swelling on the back followed by lower limb weakness. Meningocele was reported in 11.2%, myelomeningocele in 47.2%, myelomeningocele & hydrocephalus in 12.4%, tethered cord syndrome in 25.8%, and diastematomyelia 3.4% of patients. Excision combined with the repair was done in 58.4%, release & repair done in 29.2% and endoscopic third ventriculostomy/ventriculoperitoneal shunts with the repair were done in 12.4% patients. Cerebrospinal fluid leak was ...
Principles and Practice of Pediatric Neurosurgery, 2008
By definition, occult spinal dysraphism (OSD) is characterised by intact overlying skin, although most patients have some form of cutaneous stigmata. Because the underlying pathology is so variable, the clinical presentation and course of the condition vary significantly from severely disabling to asymptomatic throughout life. Management usually requires a multidisciplinary team of paediatricians, paediatric neurosurgeons, urologists, orthopaedic surgeons, occupational therapists, physiotherapists and geneticists. Although the spectrum of dysraphic abnormalities includes cranial anomalies (encephalocele), this article will focus on the spinal manifestations.