García C, Daza C, Zuleta A, Huete I, Winter A
Departamento de Radiología, Hospital Clínico Universidad Católica de Chile.
Rev Chil Pediatr. 1991 Sep-Oct;62(5):302-8.
Spinal dysraphism is relatively common in children and includes a wide spectrum of congenital anomalies in the normal closure of the posterior elements of the spine. The prognosis will depend mostly on early diagnosis and treatment. Occult spinal dysraphism may present without external anomalies and the diagnosis could be suspected lately, when neurological symptoms are present and often irreversible. Occult spinal dysraphism is frequently associated to a tethered cord, most commonly secondary to the presence of a lipoma. Ultrasonography has been proven highly sensitive in the detection of intraspinal anomalies, especially in the diagnosis of tethered cord, in children under two years of age due to lack of ossification of the posterior elements of the spine. Today ultrasonography should be the examination of choice in all those patients in whom some kind of spinal dysraphism is suspected. We report our experience with three infants with occult spinal dysraphism in whom diagnosis was initially made by US and later on proved by either computed tomography, magnetic resonance or myelography. All of them had corrective surgery and neurological abnormalities were not detected afterwards.
脊柱裂在儿童中相对常见,包括脊柱后部结构正常闭合过程中的一系列先天性异常。预后主要取决于早期诊断和治疗。隐匿性脊柱裂可能没有外部异常表现,当出现神经症状且往往不可逆转时,诊断可能会延迟作出。隐匿性脊柱裂常与脊髓拴系相关,最常见的原因是脂肪瘤的存在。由于脊柱后部结构在两岁以下儿童中尚未骨化,超声检查已被证明在检测脊柱内异常方面高度敏感,尤其是在诊断脊髓拴系方面。如今,对于所有怀疑有某种脊柱裂的患者,超声检查都应作为首选检查方法。我们报告了3例隐匿性脊柱裂婴儿的病例,其诊断最初通过超声作出,后来经计算机断层扫描、磁共振成像或脊髓造影证实。所有患儿均接受了矫正手术,术后未发现神经异常。