Congenital Spine and Spinal Cord Malformations— Self-Assessment Module (original) (raw)
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Journal of children's orthopaedics, 2016
Congenital malformations of the bony vertebral column are often accompanied by spinal cord anomalies; these observations have been reinforced with the use of magnetic resonance imaging (MRI). We hypothesized that the incidence of cord anomalies will increase as the number and complexity of bony vertebral abnormalities increases. All patients aged ≤13 years (n = 75) presenting to the pediatric spine clinic from 2003-2013 with congenital bony spinal deformity and both radiographs and MRI were analyzed retrospectively for bone and neural pathology. Chi-squared analysis was used to compare groups for categorical dependent variables. Independent t tests were used for continuous dependent variables. Significance was set at p < 0.05. Fifty-five percent of congenital spine deformity patients (n = 41) had associated spinal cord anomalies on MRI. Complex bony abnormalities had a higher incidence of cord anomalies than simple abnormalities (67, 37 %; p = 0.011). Mixed deformities of segment...
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.
Imaging in spine and spinal cord malformations
European Journal of Radiology, 2004
Spinal and spinal cord malformations are collectively named spinal dysraphisms. They arise from defects occurring in the early embryological stages of gastrulation (weeks 2-3), primary neurulation (weeks 3-4), and secondary neurulation (weeks 5-6). Spinal dysraphisms are categorized into open spinal dysraphisms (OSDs), in which there is exposure of abnormal nervous tissues through a skin defect, and closed spinal dysraphisms (CSD), in which there is a continuous skin coverage to the underlying malformation. Open spinal dysraphisms basically include myelomeningocele and other rare abnormalities such as myelocele and hemimyelo(meningo)cele. Closed spinal dysraphisms are further categorized based on the association with low-back subcutaneous masses. Closed spinal dysraphisms with mass are represented by lipomyelocele, lipomyelomeningocele, meningocele, and myelocystocele. Closed spinal dysraphisms without mass comprise simple dysraphic states (tight filum terminale, filar and intradural lipomas, persistent terminal ventricle, and dermal sinuses) and complex dysraphic states. The latter category further comprises defects of midline notochordal integration (basically represented by diastematomyelia) and defects of segmental notochordal formation (represented by caudal agenesis and spinal segmental dysgenesis). Magnetic resonance imaging (MRI) is the preferred modality for imaging these complex abnormalities. The use of the aforementioned classification scheme is greatly helpful to make the diagnosis.
Congenital Spinal Anomalies – Role of X- rays and MRI
2020
Background: Spine is a longitudinal structure, and precise location of the level of a lesion using clinical examination can be difficult. X-Ray is the primary modality of choice; they demonstrate bony anomalies better in less time and are cost effective, while MRI of spine shows the anatomy of the vertebrae that makes up the spine, as well as the discs, spinal cord and the intervertebral foramina through which the nerves pass. It also allows us to differentiate between healthy tissue and diseased tissue. Aim and objectives: The primary aim of the study was to evaluate the role of MRI and X-ray in congenital spinal anomalies. The secondary objectives were: (a) study the appearance of various congenital spinal diseases on MRI and X-ray; (b) usefulness of MRI and X-ray in determining the type of congenital spinal anomalies and (c) to compare the findings of MRI and X-ray. Materials and methods: The present study was conducted at Department of Radiodiagnosis, SBKS Medical Institute and ...
Spinal dysraphic anomalies; classification, presentation and management
Paediatrics and Child Health, 2014
Spinal dysraphism comprises an array of congenital anomalies of spinal cord development. Each of the dysraphic disorders can result in neurological, orthopaedic and urological dysfunction. This potentially confusing array of conditions is best understood from the embryological perspective. Whilst not all of these conditions are managed in the same way similar principles govern the initial investigation, multidisciplinary evaluation and long term follow up of these cases.
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.
Imaging spectrum of spinal dysraphism on magnetic resonance: A pictorial review
World journal of radiology, 2017
Congenital malformations of spine and spinal cord are collectively termed as spinal dysraphism. It includes a heterogeneous group of anomalies which result from faulty closure of midline structures during development. Magnetic resonance imaging (MRI) is now considered the imaging modality of choice for diagnosing these conditions. The purpose of this article is to review the normal development of spinal cord and spine and reviewing the MRI features of spinal dysraphism. Although imaging of spinal dysraphism is complicated, a systematic approach and correlation between neuro-radiological, clinical and developmental data helps in making the correct diagnosis.