Prospective Evaluation of Role of MRI in Suspected Spinal Dysraphism and Its Management
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 5
Abstract
Spina bifida literally means “spine in two parts” or “open spine”. Spinal dysraphism involves a spectrum of congenital anomalies resulting in a defective neural arch through which meninges or neural elements are herniated, leading to a variety of clinical manifestations. They are divided into aperta (visible lesion) and occulta (with no external lesion). Meningocele, myelomeningocele, lipomeningomyelocele, myeloschisis and rachischisis are the usual names associated depending on the pathological findings. Meningocele by definition involves only the meninges with no neural involvement; others have variable extent of neural involvement. The spina bifida aperta is usually associated with skin defect with an impending risk of CSF leak constituting “open defects,” whereas the occult forms have normal skin cover. Both forms demand different approaches in their management. The clinical importance of occult lesion has grown tremendously in the recent years. AIMS: To demonstrate the spectrum of MRI findings in spinal dysraphism and its management. MATERIALS AND METHODS: Prospective evaluation of 66 patients with suspected spinal dysraphism on 1.5 T MRI. RESULTS: Age of the patients ranged from 17 days to 13 years. Commonest clinical presentation was swelling in the back. Open spinal dysraphism, in which lumbosacral myelomeningocele was most common presentation. Diastematomyelia was the next most common presentation. Associated abnormalities like hydrocephalus, Arnold–Chiari, syrinx, hydronephrosis were commonly encountered in open defects. We have one case of open spinal dysraphism with osseous hamartoma. MRI with its multiplanar capabilities and superior soft tissue contrast, allows detection of detailed anatomy and characterization of congenital spinal disorders. CONCLUSION: MRI is an excellent imaging modality for visualizing the spinal cord at all ages and is the imaging modality of choice for defining complex spinal dysraphism.
Authors and Affiliations
Deepthi T, Karunakar CH
Keywords
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- EP ID EP373884
- DOI 10.9790/0853-1705012128.
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