Spine ultrasounds should not be routinely performed for patients with simple sacral dimples

Abstract

Sacral dimples do not predict underlying spinal cord malformations, and spine ultrasounds should not be performed for neonates with simple sacral dimples.

Optimal Timing of Spinal Ultrasound Evaluations for Sacral Dimples in Neonates: Earlier May Not Be Better

“…Although the symptoms of these anomalies do not occur until 3 years of age, screening using spinal US can detect occult spinal dysraphism in neonates who have skin‐covered lesions . Only early diagnosis can enable proper management before symptoms develop; spinal imaging is used as a screening tool for almost all clinically suspected cases . Spinal US and MRI are used as the primary diagnostic tools.…”

“…3,5,6 Only early diagnosis can enable proper management before symptoms develop; spinal imaging is used as a screening tool for almost all clinically suspected cases. 3,5,6,10 Spinal US and MRI are used as the primary diagnostic tools. With sensitivity comparable with that of MRI, spinal US is increasingly being used as the initial screening tool.…”

“…Clinically diagnosed cases of a simple sacral dimple were excluded from US evaluations. A simple sacral dimple was defined as a dimple located in the midline, within the gluteal cleft, and within 2.5 cm of the anus without any associated abnormal masses or skin lesions . In addition, there should be no associated abnormal masses or skin lesions .…”

“…A simple sacral dimple was defined as a dimple located in the midline, within the gluteal cleft, and within 2.5 cm of the anus without any associated abnormal masses or skin lesions . In addition, there should be no associated abnormal masses or skin lesions . Sacral dimples of greater than 2.5 cm from the anus, with cutaneous findings (including hemangiomas and caudal appendages), deviating from the gluteal fold, with associated neurologic symptoms, and those associated with other complex anomalies were considered to be clinically important .…”

“…[10][11][12] In addition, there should be no associated abnormal masses or skin lesions. [10][11][12] Sacral dimples of greater than 2.5 cm from the anus, with cutaneous findings (including hemangiomas and caudal appendages), deviating from the gluteal fold, with associated neurologic symptoms, and those associated with other complex anomalies were considered to be clinically important. [10][11][12][13] Cutaneous markers noted in those patient groups included vascular lesions (n = 5), skin discoloration (n = 3), tags or appendages (n = 7), and hair tufts (n = 13).…”