The value of ultrasonic examination of the lumbar spine in infants with specific reference to cutaneous markers of occult spinal dysraphism

Robinson, Ashley; Russell, Shirley B.; Rimmer, S.

doi:10.1016/j.crad.2004.06.004

Cited by 74 publications

(73 citation statements)

References 45 publications

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“…Our study likewise indicated that intraspinal lesions were significantly more frequent when the dimples were accompanied by other congenital anomalies. Although many clinicians do not consider simple dimples to require radiographic evaluation, 1,[5][6][7]12,13,15,20 in the present study, MRI revealed that 16.7% of the dimples were associated with FTF. Moreover, a low conus was found in 42.9% of the cases with FTF-associated dimples.…”

mentioning

confidence: 71%

“…Ben-Sira et al used ultrasound to screen 254 neonates with midline skin stigmata 1 and found no pathological findings in any of the 109 cases with simple dimples. Other studies have also reported normal ultrasound results in most patients with sacrococcygeal dimples 6,7,12,15 and suggested that ultrasound screening is not necessary for infants with low-risk lesions, such as simple dimples. This finding contrasts with our study, in which 16.7% of the patients with simple dimples (both deep and shallow) had FTF, and 7% also had a low conus.…”

Section: Discussionmentioning

confidence: 99%

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Intraspinal lesions associated with sacrococcygeal dimples

Harada¹,

Nishiyama²,

Yoshimura³

et al. 2014

PED

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Object Sacrococcygeal dimples in the gluteal fold, also known as coccygeal pits, are observed in 2%–4% of newborns. Sacrococcygeal dimples are not generally considered to be associated with a significant risk of intraspinal anomalies and therefore are not thought to require further radiographic evaluation. Accordingly, the precise incidence and nature of intraspinal lesions that may be associated with sacrococcygeal dimples is unclear. This study was conducted to determine the incidence of intraspinal lesions in patients with intergluteal dimples. Methods In this study, the authors used MRI to evaluate 103 children who were seen at the Niigata University Medical and Dental Hospital between 2006 and 2011 because of skin abnormalities in the lumbosacral region. Of these children, 14 were excluded as having a subcutaneous fatty mass, and 5 were excluded because the dimples were above the gluteal fold or did not end at the coccyx. The remaining 84 patients were classified according to whether the bottom of the dimple was visible (shallow) or not (deep). The authors also retrospectively examined other skin abnormalities and coexisting anomalies. Results The mean age at the time of MRI evaluation was 11.7 months. Magnetic resonance imaging led to the identification of fibrolipoma of the terminal filum (FTF) in 14 cases (16.7%); 6 of these patients also had a low conus. Classified by depth, there were 58 cases with shallow and 26 with deep dimples. Fibrolipoma of the terminal filum was found in significantly more patients with deep dimples (9 [34.6%]) than in those with shallow dimples (5 [8.6%]). The frequency of other congenital anomalies was significantly higher in patients with FTF-associated dimples (6 [42.9%] of 14) than in those with dimples that were not associated with FTF (9 [12.9%] of 70). Conclusions Fibrolipoma of the terminal filum was identified by MRI in 16.7% of patients with sacrococcygeal dimples. The risk of FTF increased when the dimples were deeply excavated or were accompanied by congenital anomalies. Magnetic resonance imaging should be performed to identify intraspinal lesions when there are high risk factors for intraspinal abnormalities, or when an ultrasound screening suggests intraspinal abnormalities.

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confidence: 71%

Section: Discussionmentioning

confidence: 99%

Intraspinal lesions associated with sacrococcygeal dimples

Harada¹,

Nishiyama²,

Yoshimura³

et al. 2014

PED

View full text Add to dashboard Cite

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“…They determined that 40% of USG examinations showed full agreement with MRI, 47% had partial agreement and 13% had no agreement [33]. Robinson et al[ 14] investigated the rationale behind the concept that the USG was useful in screening for dysraphism in infants with cutaneous markers such as a sacral dimple or hairy patch. They concluded that as an isolated abnormality, simple dimples or pits are not useful markers of spinal dysraphism.…”

Section: Discussionmentioning

confidence: 99%

“…Bladder dysfunction represents another group of symptoms. Early diagnosis with ultrasonography (USG), CT scan and/or MRI is mandatory for the examination [14, 15]. MRI has the important role of determining the presence of spinal dysraphism and its associated disorders because of its high specificity and resolution.…”

Section: Introductionmentioning

confidence: 99%

Correlation of Cutaneous Lesions with Clinical Radiological and Urodynamic Findings in the Prognosis of Underlying Spinal Dysraphism Disorders

Sasani

Asghari²,

Asghari

et al. 2008

Pediatr Neurosurg

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Spinal dysraphism is characterized by a lack of fusion of the vertebral arches that occurs in the absence of spinous processes with variable amounts of lamina. Here, we retrospectively present the importance of cutaneous lesions and their correlation with clinical presentation, radiological examination and urodynamic assessment. We retrospectively reviewed 612 (6.12%) cases with skin lesions from 10,000 consecutive live-born children seen at two institutions between January 1998 and March 2005. We divided all children into a control group and three groups based on clinical assessment, radiological examination and urodynamic evaluation results. Neurological deficits were identified in 113 (18.46%) children, while spinal dysraphism disorders, tethered cord syndrome and associated orthopedic malformations were found in 171 (27.94%), 119 (19.45%) and 28 (4.57%) patients, respectively. The incidence of tethered cord with lumbosacral dimple lesions over the sacrum (32/119, 26.65% of patients) was 3.5-fold higher than that of lesions found over the coccyx (9/119, 7.5% of patients). Uroneurological symptoms were found in 207/612 (33.82%) children. Urodynamic assessment revealed decreased bladder capacity in 10% of patients, detrusor hyperflexia during filling in 47% and a low-compliance detrusor in 71%. Discordance between ultra- sonography and MRI was found in 16.58% of patients. Spinal cord untethering was performed for 109 patients. Nearly all children with resolution were at the end of their follow-up period (24 months). Retethering occurred in 21 (19.26%) patients, and a second untethering surgery was performed in 12 patients. When spina bifida was associated with lumbar skin lesions, there may have been an increased incidence of tethered cord and other spinal cord disorders. MRI scans are more reliable and give an exact diagnosis of tethered cord. Neurological and uroneurological instability are ultimately a clinical diagnosis, and there is controversy about their indications for surgery. However, the correlation between urodynamic assessment and cutaneous lesions with a tethered cord found by MRI examination allow for an early diagnosis and the possibility of prompt treatment.

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“…In this study, meningocele manqué were defined as abnormal, dorsally located bands that tether the spinal cord to surrounding tissues (Schmidt et al, 2017;; Tubbs et al, 2003). A focal hairy match may also occur alongside other lesions such as dimples or skin pits and be associated with spinal dysraphism that warrants further investigation (Robinson, Russell, and Rimmer, 2005). Localized hypertrichosis associated with OSD is often located in the lumbosacral region, and is V-shaped and poorly circumscribed in appearance (Drolet, 2000).…”

Section: Hypertrichosis and Focal Hirsutismmentioning

confidence: 99%

Cutaneous Lesions Indicating Occult Spinal Dysraphisms: A Review

Johal¹,

Loukas²,

Oakes³

et al. 2017

The Spine Scholar

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Skin changes are often the first indication of an underlying spinal dysraphism. Using standard search engines, the association between cutaneous stigmata and underlying occult spinal dysraphisms were reviewed. Various spinal dysraphisms have skin changes that are frequently associated with them. Others, however, are not as indicative of a specific dysraphism. The clinician should have a high index of suspicion in patients with cutaneous

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The value of ultrasonic examination of the lumbar spine in infants with specific reference to cutaneous markers of occult spinal dysraphism

Cited by 74 publications

References 45 publications

Intraspinal lesions associated with sacrococcygeal dimples

Intraspinal lesions associated with sacrococcygeal dimples

Correlation of Cutaneous Lesions with Clinical Radiological and Urodynamic Findings in the Prognosis of Underlying Spinal Dysraphism Disorders

Cutaneous Lesions Indicating Occult Spinal Dysraphisms: A Review

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