Illuminating the Hidden Spine: A Pediatric Case Series of Spinal Dysraphisms via Multimodality Imaging

Spinal dysraphisms are a spectrum of congenital malformations arising from defective closure of the neural tube. They range from open anomalies such as myelomeningocele to occult lesions like dermal sinus tracts and tethered cords. Early diagnosis through imaging is crucial for timely surgical intervention and preventing neurological sequelae. Eleven cases were retrospectively analyzed. Imaging modalities included spinal ultrasonography (for neonates and infants), MRI (T1/T2 sagittal and axial sequences), and CT in selected cases to evaluate bony anomalies. Clinical presentation and imaging findings were correlated. The spectrum includes lipomeningoceles (n=3), myelomeningoceles (n=3), meningocele (n=2), diastematomyelia (n=2), dermal sinus tract (n=1), and associated anomalies including tethered cord, hydrosyrinx, and Arnold Chiari malformation type II. MRI was the most sensitive tool for delineating neural structures, while USG was invaluable in neonates. CT contributed significantly to identifying osseous abnormalities in diastematomyelia. Multimodal imaging plays a pivotal role in detecting and classifying spinal dysraphisms in children. USG is the preferred initial tool in infants, while MRI remains the gold standard for comprehensive evaluation. Early recognition significantly impacts surgical planning and prognosis.