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A case of Spina bifida occulta

- Amongst neural tube defects, the disorders involving spine, vertebral column and nerve roots are included in spinal dysraphisms. They can be classified as

  • Spina bifida aperta (open defects) 
  • Spina bifida occulta (closed defects)

- There is no specific treatment required for occult spina bifida if the abnormality is limited to the bone.

- Usually these deformities are found at the last lumbar vertebrae (L5) or at the first sacral vertebrae (S1)

- Faun's Tail is an abnormal lumbosacral hypertrischosis associated with spinal dysrasphisms

- A posterior lumbar bony defect is often present in 5% to 10% of the normal population, without any symptoms or deficits

- If other markers such as a tuft of hair, cutaneous hemangioma, or sinus tract are present, further investigations should be done.

- The term spina bifida occulta includes following:

  • Simple Spina Bifida Occulta: Mildest form of spina bifida. Usually asymptomatic.
  • Dermal Sinus: Dermal sinus tract from the cutaneous to spinal subarachnoid space. It can cause ascending infection
  • Diastematomyelia: Spinal cord is split into two hemicords, often by a bony or fibrous band that tethers the cord. Needs to be repaired surgically
  • Lipomyelomeningocele: There is fatty tissue in the spinal cord and in the spinal canal tethering the cord. Associated neurologic deficits, although uncommon at birth, usually develop later because of the tethering

Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice, 20e