PEDIATRIC SPINAL DYSRAPHISM ON MAGNETIC RESONANCE IMAGING: TRENDS IN A TERTIARY CARE HOSPITAL IN NORTH INDIA

Abstract

Background: Spine and spinal cord development is governed by intricate genetic mechanisms and any deviation from the normal embryological cascade during 2-6 gestational weeks causes imperfect fusion of midline mesenchymal, bony and neural structures causing spinal dysraphism. Imaging plays a pivotal role in their evaluation as many patients present with concurrent anomalies that need to be corrected simultaneously to avoid repeat surgeries. To demonstrate the spectrum of MRI ndings of spinal dysraphi Aim: Settings and design: sm. A cross sectional observational study was done in 36 pediatric patients with known or suspected spinal dysraphism on 3T MRI. MRI was Materials And Methods: performed using Siemens Skyra 3T MRI. In this study comprising of 36 patients, mean age Results: was 37.1months (3 years 1month) with minimum age of 4 days and maximum age of 18 years. Children of age less than 5 years were maximally affected. A female predominance was noted with male: female ratio of 0.9:1. Open spinal dysraphism (55.6%) was more common than closed dysraphism (44.4%). The most common dysraphism was myelomeningocele. Among open dysraphism, we also encountered 1 case each of hemimyelomeningocele and myelocele. Among closed defects, split cord malformation was most common (19.4%) as it was present with other dysraphic defects (called complex spina bida), followed by lipomyelocele (11.1%) and dermal sinus (11.1%). Among 7 cases of split cord malformation, type II (6 cases; 85.7%) was more common than type I (1 case; 14.3%). Other cases of closed dysraphism were lipomyelomeningocele, meningocele, terminal myelocystocele, intradural lipoma, lar lipoma and caudal regression syndrome. MRI is an excelle Conclusion: nt modality for dening the characteristic imaging features of each dysraphism to give a composite diagnosis.