Closed spinal dysraphism: Clinical manifestations, diagnosis, and management
- Chaouki Khoury, MD, MS
Chaouki Khoury, MD, MS
- Associate Professor of Neurology and Child Neurology
- Texas A&M Health Sciences Center
- Section Editors
- Marc C Patterson, MD, FRACP
Marc C Patterson, MD, FRACP
- Section Editor — Pediatric Neurology
- Professor of Neurology, Pediatrics, and Medical Genetics
- Chair, Division of Child and Adolescent Neurology
- Mayo Clinic College of Medicine
- Moise L Levy, MD
Moise L Levy, MD
- Section Editor — Pediatric Dermatology
- Professor of Pediatrics and Medicine (Dermatology)
- Dell Medical School, University of Texas, Austin
- Clinical Professor of Dermatology and Pediatrics
- Baylor College of Medicine
Neural tube defects are congenital anomalies of neural development with a spectrum of clinical manifestations; they can affect the cranium or spine.
●Open spinal dysraphism (spina bifida aperta) is characterized by a cleft in the spinal column, with herniation of the meninges (meningocele) or meninges and spinal cord (myelomeningocele) through the defect. (See "Pathophysiology and clinical manifestations of myelomeningocele (spina bifida)" and "Overview of the management of myelomeningocele (spina bifida)".)
●Closed spinal dysraphism (CSD) (also known as occult spinal dysraphism or spina bifida occulta) is characterized by failure of fusion of the vertebral bodies due to abnormal fusion of the posterior vertebral arches, with unexposed neural tissue; the skin overlying the defect is intact. The more common and least severe forms consist of isolated vertebral bony defects. However, the vertebral defects may occur in association with other more severe anomalies of the spinal cord and sacral structures, such as split spinal cord malformation or various cavitary defects of the spinal cord.
This topic will review the clinical manifestations, diagnosis, and management of closed spinal dysraphism. The etiology and different forms of closed spinal dysraphism are reviewed elsewhere. (See "Closed spinal dysraphism: Pathogenesis and types".)
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- TYPES OF CLOSED SPINAL DYSRAPHISM
- CLINICAL MANIFESTATIONS
- - Tethered cord syndrome
- Other malformations
- EVALUATION AND DIAGNOSIS
- Ultrasound of abdomen and pelvis
- SUMMARY AND RECOMMENDATIONS