Diagnostic Utility of Spinal Ultrasounds in Neonates

Area of Science:

• Neonatal imaging
• Pediatric radiology
• Diagnostic utility of medical imaging

Background:

• Ultrasound (US) is a primary imaging tool for neonatal spinal anomalies.
• Many indications for spinal US in newborns yield limited diagnostic information.
• Caudal regression syndrome (CRS) is a complex condition requiring accurate diagnosis.

Purpose of the Study:

• To assess the indications and diagnostic utility of spinal US in newborns.
• To review patient presentations of caudal regression syndrome (CRS) identified via spinal US.
• To evaluate the long-term outcomes of infants with abnormal spinal US findings.

Main Methods:

• Retrospective review of 592 spinal US examinations performed between 2006 and 2021.
• Analysis of indications for US, associated abnormalities, and diagnostic yield.
• Detailed review of patient presentations and outcomes for caudal regression syndrome (CRS).

Main Results:

• Only 12% of spinal US examinations were abnormal.
• Sacral dimple, the most common indication, had a low abnormality rate (4%) and low diagnostic yield.
• Anorectal anomalies (OR 7.55) and spinal mass (OR 17.99) were strongly associated with abnormal US findings.

Conclusions:

• Spinal US demonstrates a low overall diagnostic yield in the neonatal population.
• While common, sacral dimples rarely indicate significant pathology via spinal US.
• Anorectal anomalies represent a key indication with a high likelihood of abnormal US findings.