Natural History of Occult Spinal Dysraphism

  • Jeffrey P. BlountEmail author
  • Zachary G. Wright


The natural history of the occult dysraphic lesions has never been comprehensively studied, and collective understanding remains incomplete. The unifying event that is widely considered central to all OSDs is tethered cord syndrome (TCS). The evidence that this phenomenon directs the natural history of the OSDs is empirical and originates from early observations that young patients harboring OSDs are less impaired than older ones. As longer follow-up and more comprehensive observation have occurred, it has become evident that there is at least some variability in the natural history of some occult dysraphic lesions. DSTs and SCMs appear to have high rates of progressive decline from TSC, but there is greater variability in the lipomas. Up to 50% of conus lipomas may demonstrate minimal progression of signs and symptoms, and filar lipomas are common incidental findings that are likely of variable significance. Patient registries and studies of better design will be required to advance understanding of the natural history of the occult spinal dysraphisms.


Occult dysraphism Natural history Dermal sinus tract Split cord malformation Conus lipoma Filum lipoma 



Dermal sinus tract


Occult spinal dysraphism


Split cord malformation


Tethered cord syndrome


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Pediatric NeurosurgeryChildren’s of AlabamaBirminghamUSA

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