Spinal dysraphic anomalies; classification, presentation and management (original) (raw)

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...

Congenital Spine and Spinal Cord Malformations— Self-Assessment Module

American Journal of Roentgenology, 2010

Congenital abnormalities of the spine and spinal cord are referred to as spinal dysraphisms. This article reviews nor mal embryological development of the spine and spinal cord and the imaging findings of congenital abnormalities of the spine and spinal cord with particular focus on MRI. Conclusion Knowledge of the normal development of the spine and spinal cord provides a framework for understanding these complex entities.

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.

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%).

Surgical Management of Spinal Dysraphism: Five -year Experience in a Central Hospital

Journal of Nepal Paediatric Society, 2014

Introduction: Spinal dysraphism is a heterogeneous group of congenital spinal anomalies resulting from defective closure of the neural tube early in fetal life and anomalous development of the caudal cell mass. Meningomyelocele is common among Neural tube defects. Patients with myelomeningocele present with a spectrum of impairments, including primary functional deficits like are lower limb paralysis, sensory loss, bladderbowel dysfunction and cognitive dysfunction. Medical, surgical management and rehabilitation have helped patients with neural tube defects to participate and be productive in mainstream society. The aims of this study were to review the clinical presentation, surgical management and their outcome in the patient with spinal dysraphism. Materials and Methods: This is a retrospective study of Forty-one cases of spinal dysraphism managed during a period of five years from January 2008 to December 2012 in Department of Neurosurgery, National Academy of Medical Sciences ...

Congenital spinal deformity: assessment, natural history and treatment

Orthopaedics and Trauma, 2017

Congenital spinal deformity is caused by vertebral anomalies that produce an imbalance in spinal growth. Anomalies can be classified as failures of vertebral formation, failures of segmentation or a mixture of both. The natural history and risk of deformity progression depends on the anatomical location and type of anomaly. Patients should be assessed with a thorough clinical evaluation including investigations for renal, cardiac and intraspinal anomalies. Timely diagnosis and estimation of risk of progression is required to allow early surgical intervention before a severe curve develops. This may take the form of in situ fusion or hemi-epiphysiodesis where there is minimal deformity. In moderate deformities a posterior instrumented correction and fusion may be needed, while in severe deformities osteotomies or vertebral column resection may be required. Surgery in patients with congenital spinal deformity carries a risk of neurological injury so an early simple surgical treatment should be favoured to minimize the risk of complications.

Prenatal diagnosis of segmental spinal dysgenesis

Prenatal Diagnosis, 2007

A 20-year-old woman (gravida 1, para 0) was referred at 22 weeks and 3 days of gestation with bilateral talipes and a suspected spinal abnormality. The nuchal translucency assessed at 12 weeks and 3 days was 2.3 mm with a CRL (crown-rump length) of 59.8 mm giving an adjusted risk for Down syndrome of 1 : 825. The patient had an uneventful medical history, and no history of abdominal trauma was elicited. We performed a detailed 2D-3D ultrasound examination of the fetal anatomy. This confirmed the finding of bilateral talipes, and reduced movements across the knee joint on both sides were observed. In addition, complete disjunction of the thoracic and lumbar spine at the L1 and L2 level was seen ). There was no spina bifida or hemivertebra nor any evidence of Arnold Chiari malformation or further associated structural abnormalities.