This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
- Holly A. Zywicke, MD*
- Curtis J. Rozzelle, MD†
- *Division of Pediatric Neurosurgery, Department of Surgery, University of Alabama at Birmingham and Children's Hospital of Alabama, Birmingham, AL.
- †Assistant Professor, Department of Surgery, Division of Pediatric Neurosurgery, University of Alabama at Birmingham and Children's Hospital of Alabama, Birmingham, AL.
Author Disclosure
Drs Zywicke and Rozzelle have disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
Objectives
After completing this article, readers should be able to:
Explain the difference between open and closed neural tube defects.
Describe the characteristics of spinal skin dimples that warrant further evaluation.
Describe the characteristics of spinal skin dimples that do not warrant further evaluation.
Discuss the evaluation of spinal skin dimples and name the findings that suggest occult spinal dysraphism.
Discuss the neurosurgical treatment of occult spinal dysraphism.
Explain the natural history and clinical manifestations of occult spinal dysraphism.
Definitions
Neural tube defects are among the most common forms of birth defect, affecting 1 in every 1,000 pregnancies. (1)(2) These defects, which result from abnormal fusion of the neural tube during embryonic development, are placed into two broad categories: open and closed. Open neural tube defects are lesions in which brain, spinal cord, or spinal nerves are exposed through obvious defects of the meninges and skull or vertebral column. Examples are anencephaly, myelomeningocele, and meningocele. Closed neural tube defects are skin-covered lesions under which the nervous system structures have not formed normally. These include split cord malformation, dermal sinus tract, tethered spinal cord, and intraspinal lipoma (Table).
- In this window
- In a new window
Definitions
Spina bifida is an imprecise term often used to describe a variety of congenital spinal anomalies that range in consequence from insignificant to severe. Spina bifida occulta (SBO) is a radiographic finding that describes incomplete osseous fusion of the posterior elements. It may occur in conjunction with a cutaneous abnormality but is clinically benign and is considered a normal variant. (3) Occult spinal dysraphisms (OSDs) are much less common than SBO and encompass a variety of skin-covered neural tube defects. Because …
Individual Login
Institutional Login
You may be able to gain access using your login credentials for your institution. Contact your librarian or administrator if you do not have a username and password.
Log in through your institution
Pay Per Article - You may access this article (from the computer you are currently using) for 2 days for US$25.00
Regain Access - You can regain access to a recent Pay per Article purchase if your access period has not yet expired.