SKIN-LESIONS OF THE SPINAL AXIS AND SPINAL DYSRAPHISM - 15 CASES AND A REVIEW OF THE LITERATURE

Objective: To catalog the paraspinal skin lesions of early childhood t hat are associated with occult spinal dysraphism. Research Design: Ret rospective review of a series of patients. Setting: Tertiary care refe rral center. Patients: Fifteen patients who had significant paraspinal skin lesions were identified from the personal files of the authors w ho saw them. Results: The skin lesions included various combinations o f hyperpigmentation, hypopigmentation, hypertrichosis, acrochordons, d imples, lipomas, hemangiomas, or teratomas. Not all lesions were evalu ated with the same tests, which included plain roentgenography, ultras onography, myelography, computed tomography, and magnetic resonance im aging. Of the 15 patients, six had spinal anomalies, eight had no appa rent spinal dysraphism, and one had insufficient results of the evalua tion to assess the spinal column. Conclusions: Early recognition of pa raspinal skin lesions is essential to prevent neurologic damage. Urina ry or fecal incontinence, recurrent urinary infections, muscle atrophy , foot deformities, weakness, pain, or decreased sensation in the lowe r extremities may eventually develop in these patients. Magnetic reson ance imaging appears to be the single best screening test for dysraphi sm.