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Updated: Aug 25, 2026
Intraoperative Ultrasound in Spinal Surgery
Published on: August 17, 2022
[Ultrasonography in spinal dysraphism and tethered cord]
1Departamento de Radiología, Hospital Clínico Universidad Católica de Chile.
Insights
Early diagnosis of occult spinal dysraphism using ultrasonography (US) is crucial for timely treatment. This imaging technique effectively detects spinal anomalies, including tethered cords, in infants, preventing irreversible neurological damage.
Area of Science:
- Pediatric Neurology
- Diagnostic Imaging
- Developmental Biology
Background:
- Spinal dysraphism encompasses congenital anomalies of posterior spinal element closure.
- Occult spinal dysraphism often lacks external signs, leading to delayed diagnosis and potential irreversible neurological deficits.
- Tethered cord, frequently linked to lipomas, is a common complication of occult spinal dysraphism.
Purpose of the Study:
- To evaluate the efficacy of ultrasonography (US) in diagnosing occult spinal dysraphism in infants.
- To highlight the importance of early US detection for timely intervention and improved prognosis.
- To present case studies of infants diagnosed with occult spinal dysraphism via US.
Main Methods:
- Retrospective analysis of three infant cases with suspected occult spinal dysraphism.
- Initial diagnosis of intraspinal anomalies using ultrasonography (US).
- Confirmation of diagnoses through computed tomography (CT), magnetic resonance imaging (MRI), or myelography.
Main Results:
- Ultrasonography proved highly sensitive in detecting intraspinal anomalies, including tethered cords, in infants under two years.
- US facilitated early diagnosis in all three reported cases of occult spinal dysraphism.
- Post-surgical follow-up revealed no neurological abnormalities in the patients.
Conclusions:
- Ultrasonography is the recommended imaging modality for suspected spinal dysraphism in infants due to its high sensitivity and ability to visualize intraspinal structures.
- Early diagnosis and surgical correction of occult spinal dysraphism, particularly tethered cords, can prevent long-term neurological complications.
- US plays a vital role in the early detection and management of pediatric spinal anomalies.
Abstract:
Spinal dysraphism is relatively common in children and includes a wide spectrum of congenital anomalies in the normal closure of the posterior elements of the spine. The prognosis will depend mostly on early diagnosis and treatment. Occult spinal dysraphism may present without external anomalies and the diagnosis could be suspected lately, when neurological symptoms are present and often irreversible. Occult spinal dysraphism is frequently associated to a tethered cord, most commonly secondary to the presence of a lipoma. Ultrasonography has been proven highly sensitive in the detection of intraspinal anomalies, especially in the diagnosis of tethered cord, in children under two years of age due to lack of ossification of the posterior elements of the spine. Today ultrasonography should be the examination of choice in all those patients in whom some kind of spinal dysraphism is suspected. We report our experience with three infants with occult spinal dysraphism in whom diagnosis was initially made by US and later on proved by either computed tomography, magnetic resonance or myelography. All of them had corrective surgery and neurological abnormalities were not detected afterwards.
