Some aspects of occult spinal dysraphism: a study of 90 cases

Abstract

Clinical and radiological aspects of 90 patients with occult spinal dysraphism have been investigated and some of the relevant literature reviewed. Superficial lesions of the back, unilateral lower limb wasting and incontinence of urine were common clinical findings. Eighty-three patients showed major vertebral defects on plain radiographs and almost all had abnormal myelographic features. Laminectomy in 67 cases revealed the presence of a variety of abnormalities including diastematomyelia and intraspinal mass lesions such as dermoid cysts and lipomata. These developmental anomalies were frequently associated with a “foetal” type of spinal cord, situated more caudally than normal. This association is probably invariable when there is an intraspinal lipoma or low diastematomyelia. The range of possible abnormalities in occult dysraphism requires a comprehensive diagnostic approach. Radiological assessment of cases should be reliable enough to assist in forming a basis for their future management.