Clinical and MR neuroimaging features of lumbosacral spinal malformations: a tertiary care institutional experience in south India.

BACKGROUND AND AIMS: Spinal dysraphisms are a group of malformations of the spinal cord or neural elements and the meninges with or without bony and soft tissue involvement due to defects in different stages of neural tube development. We aimed to study the clinico-radiological profile of spinal lumbosacral malformations in a tertiary care institution in south India. MATERIAL AND METHODS: Clinical and MR neuroimaging features of 120 patients with congenital lumbosacral spinal malformation (113 children and 7 adults) were analyzed including skeletal abnormalities, cutaneous stigmata, and level of malformations. The malformations were divided into simple single-level defects and complex multi-level defects. RESULTS: There were 101 cases of single-level defect malformations and 19 cases of complex malformations involving multiple levels or defects. Meningoceles (11), myelomeningocele (16), lipomyelocele (29), lipomyelomeningocele (20), split cord malformation types I (17) and II (23), intradural lipoma with dural defect (7), and caudal regression syndrome (9) are the major anomalies noted. Low-lying cord and tethering were noted in both groups (> 80 and 75%). Thickened filum (40), filar lipoma (22), central canal prominence (29), and syrinx (22) are other findings. Brain MRI findings include Chiari malformation in 9 cases of myelomeningocele and corpus callosal hypoplasia in 2 cases of lipo-myelomningocele. CONCLUSIONS: Our study is an attempt to give a structured descriptive profile and classification of spinal lumbosacral malformations based on MR neuroimaging from a tertiary care institution in south India.