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- Title
Comparison of clinical disease classification and MRI findings of lumbosacral dimple.
- Authors
Hiroki Tsukada; Aya Takeyama; Masaki Ito; Jun Sakuma
- Abstract
Lumbosacral dimple is usually observed in 2%-4% of neonates. The purpose of this study is to examine the relationship between clinical disease classification of lumbosacral dimples and MRI findings. We investigated twenty-three patients diagnosed with lumbosacral dimples by magnetic resonance imaging (MRI) from January 2016 to December 2018. The lumbosacral dimples were classified according to criteria proposed by Gomi. Additionally, we generally define the height of the conus medullaris as "normal" if located at or above L2 (the second lumbar spine level) in the absence of other spinal cord abnormalities, and as "abnormal" if located below L2-L3 regardless of spinal pathology, or above with spinal pathology (e.g., syringomyelia or lipoma). Accordingly, seventeen neonates had type 1 dimples : twelve normal and five abnormal (four with filum lipomas, and one with a small cyst at the conus medullaris) ; all had no low-level conus medullaris and did not require surgical interventions. Four neonates had type 2 dimples : two normal and two abnorma( (one with a filum lipoma that was conservatively managed, and one with a combination of syringomyelia and myelomeningocele that required an untethering surgery). Two neonates had type 3 dimples : one normal and one abnormal with a low-set conus and filum lipoma that required an untethering surgery). Ultrasonography is a feasible and safe diagnostic technique for newborns with lumbosacral dimples, but it gives the best results in the hands of an expert. Although sedation carries some risk, it remains necessary in MRI for children. Pediatric MRI is the best diagnostic tool available for lumbosacral dimples; if MRI is not possible, responsible adults should be educated about clinical symptoms that would warrant follow-up.
- Publication
Fukushima Medical Journal, 2020, Vol 70, Issue 1, p1
- ISSN
0016-2582
- Publication type
Article