Standardized sonographic investigation of the lumbal spine in 247 newborns

Open dysraphism is generally known before birth due to prenatal screening b ut occult spinal malformation often remains unrecognized. Nevertheless, new borns with occult dysraphism could be easily diagnosed by ultrasound, which might be performed additionally to the neonatal screening of the hips. Ear ly surgical treatment or close neuropediatric follow-ups could be administe red as a consequence. As part of a prospective study-design, we screened the spinal cord of 247 n ewborns by ultrasound. Parents were interviewed about a positive family his tory, a folate intake during pregnancy, amniocentesis or chorionbiopsy. Cli nically, cutaneous stigmata usually associated with occult spinal dysraphis m were evaluated. An orthopedic and pediatric ic examination followed. The sonographic investigation was done in prone position using a newly designed positioning device. The sonographic examination was performed within 5 min utes and longitudinal and transversal pictures were taken for documentation . In all of the 247 examined newborns we were able to visualize the cartilagc ous structures of the spinal cord and the dural sack detailly. Dependent on the position of the newborn, variations of the width of the dural sack cou ld be noted. Thus a newly designed positioning device helped to standardize the examination situation. We did not find any pathological changes of the spinal cord. Nevertheless ultrasonography provides a useful diagnostic too l in investigating the newborn where occult spinal dysraphism is expected.