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Detailed information of SPINA BIFIDA OCCULTA
SPINA BIFIDA OCCULTA
DEFINITION:
A neural tube defect affecting the spine arising from the
incomplete closure of the neural canal in the lumbosacral region.
EPIDEMIOLOGY:
- incidence: common (5% of the population)
- age of onset:
- risk factors:
- multifactorial inheritance pattern
PATHOGENESIS:
- represent disorders of embryogenesis (induction disorders)
- account for most of the congenital anomalies of the central
nervous system (CNS)
- result from the failure of the neural tube to close
spontaneously between the 3rd and 4th week of in utero
development
- also called posterior midline lesions or dysraphia
2. Spina Bifida Occulta
- represents the most benign form of dysraphia
- not associated with abnormalities of the meninges, spinal
cord, or nerve roots
- frequently only one vertebrae is affected
- represents a posterior defect in the vertebral bodies
- may occasionally be associated with syringomyelia,
diastematomyelia, or a tethered cord
CLINICAL FEATURES:
- lower midline of back
- patch of hair, lipoma, skin discolouration, dermal sinus
- usually clinically insignificant (asymptomatic)
INVESTIGATIONS:
- defect in the closure of the posterior vertebral arches
and laminae typically involving L5 and S1
2. Prenatal Diagnosis
- normal maternal serum alpha-feto-protein (AFP)
MANAGEMENT:
- because Spina Bifida Occulta may be associated with other
developmental anomalies of the spinal column (diastematomyelia,
syringomyelia, tethered cord), patients may need to be referred
to a Neurosurgeon especially if progressive neurological
problems develop in the lower limbs such as:
- low back pain
- progressive scoliosis
- muscle weakness or wasting
- diffuse pain
- loss of pain and temperature sensation
- absent knee and/or ankle reflexes
- talipes cavus deformities
- claw toes
- overflow incontinence
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Pediatric Database - SPINA BIFIDA OCCULTA
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