O'Connor J F, Cranley W R, McCarten K M, Radkowski M A
Boston University School of Medicine, Massachusetts.
Radiol Clin North Am. 1991 Mar;29(2):407-29.
Although the foregoing review of embryologic development and congenital anomalies of the spine in infants and children is necessarily brief, the most commonly encountered abnormalities have been reviewed, and when possible, an attempt has been made to cite the stage of embryologic development at which the various abnormalities originate. As noted, congenital abnormalities of the spine are relatively uncommon but may be of profound clinical significance. During the past decade, the most significant developments in the diagnosis and treatment of these abnormalities have been ultrasonography, CT scanning, and MR imaging. In the neonate, the spinal cord and neural outflow can be evaluated by ultrasonography until the osseous elements begin to fuse. Thereafter, MR imaging is the procedure of choice because it permits evaluation of the spine and spinal cord in all planes of imaging and provides detailed evaluation of the effect of osseous abnormalities on neural structures. Finally, plain radiographs of the spine for evaluation of neonates who have any of a spectrum of sacral dimples are rarely helpful, and in the presence of significant cutaneous or subcutaneous abnormalities, ultrasonography is the preferred modality for evaluation.
尽管上述对婴儿和儿童脊柱胚胎发育及先天性异常的综述必然简短，但已对最常见的异常情况进行了回顾，并尽可能列举了各种异常情况起源时的胚胎发育阶段。如前所述，脊柱先天性异常相对少见，但可能具有深远的临床意义。在过去十年中，这些异常情况诊断和治疗方面最重要的进展是超声检查、CT扫描和磁共振成像。在新生儿中，在骨成分开始融合之前，可通过超声检查评估脊髓和神经传出情况。此后，磁共振成像是首选的检查方法，因为它可以在所有成像平面评估脊柱和脊髓，并能详细评估骨异常对神经结构的影响。最后，对于有各种骶部酒窝的新生儿，脊柱平片很少有助于评估，而在存在明显皮肤或皮下异常的情况下，超声检查是首选的评估方式。
