Is spina bifida occulta associated with lower urinary tract dysfunction in children?

Area of Science:

• Pediatric neurology
• Urology
• Radiology

Background:

• Spinal cord abnormalities, including spina bifida occulta, account for a significant portion of central nervous system congenital malformations.
• Lower urinary tract and bowel dysfunction are common in children and can be associated with various underlying conditions.

Purpose of the Study:

• To prospectively evaluate the occurrence and significance of spina bifida occulta in children presenting with lower urinary tract and bowel dysfunction.
• To determine if spina bifida occulta correlates with clinical outcomes or spinal cord abnormalities in this pediatric population.

Main Methods:

• A prospective study of 158 consecutive children with lower urinary tract and bowel dysfunction between January 1999 and February 2001.
• Plain abdominal X-rays were used to identify the presence or absence of posterior element fusion in the lumbar and sacral spinous processes, diagnosing spina bifida occulta.
• Magnetic resonance imaging (MRI) scans were utilized to assess for spinal cord abnormalities.

Main Results:

• Spina bifida occulta was identified in 36% of the evaluated children.
• A significant correlation was found between lower urinary tract dysfunction and the presence of spina bifida occulta on plain abdominal X-ray.
• No significant correlation was observed between spina bifida occulta and spinal cord abnormalities detected by MRI, nor was a direct causal relationship established with lower urinary tract dysfunction.

Conclusions:

• Children with spina bifida occulta and lower urinary tract/bowel dysfunction typically have normal genitourinary tracts and no spinal cord abnormalities.
• The findings suggest that spina bifida occulta in this cohort may be an incidental radiological finding with no established clinical significance for their dysfunction.