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Unveiling the tale of the tail: an illustration of spinal dysraphisms

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Abstract

Spinal dysraphism is an umbrella term describing herniation of meninges or neural elements through defective neural arch. They can be broadly categorized into open and closed types. MRI is the investigation of choice to study neural abnormalities and to assess the severity of hydrocephalus and Chiari malformation. Knowledge of the embryology of these disorders is valuable in correctly identifying the type of dysraphism. The aim of surgery is untethering and dural reconstruction. Accurate depiction of the abnormal anatomy in cases of spinal dysraphism is of utmost importance for surgical management of these patients. MRI makes this possible due to its excellent soft tissue contrast resolution and multiplanar capability, allowing the radiologist to evaluate the intricate details in small pediatric spinal structures. Imaging enlightens the surgeons about the status of spinal cord and other associated abnormalities and helps detect re-tethering in operated cases. Besides, antenatal surgery to repair myelomeningoceles has made detection of open dysraphisms on fetal MRI and antenatal ultrasound critical. The purpose of this review is to describe the development of spine, illustrate the myriad imaging features of open and closed spinal dysraphisms, and enlist the reporting points the operating surgeon seeks from the radiologist.

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  1. Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, 110029, India

    Anjuna Reghunath, Rohini Gupta Ghasi & Ankita Aggarwal

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  1. Anjuna Reghunath
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The work was approved by the Ethics Committee of the authors’ institution. Informed consent was obtained from all individual participants (or their guardians where applicable) included in the study. All the illustrations used in this article have been created by the first author of the article, using Adobe Illustrator Draw application. The source of the images is the database of the authors’ institute, as indicated in the title page.

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Reghunath, A., Ghasi, R.G. & Aggarwal, A. Unveiling the tale of the tail: an illustration of spinal dysraphisms. Neurosurg Rev 44, 97–114 (2021). https://doi.org/10.1007/s10143-019-01215-z

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