Diagnostic approach in an infant with spinal dysraphism

  • Nataša Šuštar Department of Child, Adolescent and Developmental Neurology, Division of Paediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia
  • Darja Paro Panjan Neonatal Unit, Division of Paediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia
  • Damjana Ključevšek Unit of radiology, Division of Paediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia
  • David Neubauer Department of Child, Adolescent and Developmental Neurology, Division of Paediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia
  • Peter Spazzapan Department of Neurosurgery, Division of Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia
  • Aneta Soltirovska Šalamon Neonatal Unit, Division of Paediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia

Abstract

Spinal dysraphisms are congenital malformations of the spinal cord and spine that occur due to impaired closure of the neural tube in early embryogenesis. According to the skin coverage, they are divided into open and closed types. While open dysraphisms can be identified by prenatal investigations, the diagnosis of a closed (occult) dysraphic state is more difficult to establish. There are specific skin signs over the spine in more than half of these patients, which can help with early diagnosis. Ultrasonography of the spine and spinal cord is the method of choice in the diagnostics of occult spinal dysraphism in the first months of life, until the spine is closed. The most sensitive diagnostic tool is magnetic resonance imaging, which also represents the gold standard of preoperative diagnostics. Early diagnosis is important in asymptomatic conditions, as this allows timely surgical treatment of children, who are at greater risk of sudden onset of complications or neurological sequelae. In the article, we summarised clinical and radiological characteristics of dysraphic conditions and formed a diagnostic algorithm to unify an approach in a child with spinal dysraphism in the first months of life.

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Published
2020-01-09
How to Cite
1.
Šuštar N, Paro Panjan D, Ključevšek D, Neubauer D, Spazzapan P, Soltirovska Šalamon A. Diagnostic approach in an infant with spinal dysraphism. ZdravVestn [Internet]. 9Jan.2020 [cited 27Feb.2020];88(11-12):539-53. Available from: https://vestnik.szd.si/index.php/ZdravVest/article/view/2914