Meling Torstein R, Due-Tønnessen Bernt J, Lundar Tryggve, Helseth Eirik
Nevrokirurgisk avdeling Rikshospitalet 0027 Oslo.
Tidsskr Nor Laegeforen. 2002 Apr 10;122(9):913-6.
Spinal dysraphism is a group of congenital anomalies of the spine characterized by a midline defect affecting the nervous tissue and its bony and soft tissue coverings. Closed spinal dysraphism, spina bifida occulta, refers to skin-covered lesions. However, there are a number of cutaneous stigmata or other physical signs that serve as indicators of an underlying dysraphic malformation of the lower spinal canal.
Based upon relevant literature, we present a review of occult spina bifida.
The cutaneous stigmata that may indicate an underlying dysraphism are particularly hairy patches, subcutaneous lipomas, capillary hemangiomas, dorsal dermal sinuses and sacral cutaneous pits. The clinical examination of a child with lumbosacral cutaneous stigmata should focus on neurological signs and symptoms, urological disturbances and orthopaedic deformities in the lower limbs. Spinal MRI is the imaging modality of choice in children presenting with features consistent with occult spinal dysraphism. Children with occult spinal dysraphism should be referred to a neurosurgical unit.
脊柱裂是一组脊柱先天性畸形,其特征为中线缺损,影响神经组织及其骨和软组织覆盖物。隐性脊柱裂,即脊柱裂隐性,指的是皮肤覆盖的病变。然而,有许多皮肤体征或其他身体体征可作为下椎管潜在闭合性脊柱裂畸形的指标。
基于相关文献,我们对隐性脊柱裂进行了综述。
可能提示潜在脊柱裂的皮肤体征尤其包括多毛斑、皮下脂肪瘤、毛细血管瘤、背侧皮窦和骶部皮肤凹陷。对患有腰骶部皮肤体征的儿童进行临床检查时,应重点关注神经体征和症状、泌尿系统紊乱以及下肢的骨科畸形。脊柱磁共振成像(MRI)是出现与隐性脊柱裂相符特征的儿童的首选成像方式。患有隐性脊柱裂的儿童应转诊至神经外科科室。