The Role of Ultrasound Investigation: Sacral Dimples and Other Stigmata of Spinal Dysraphism in Infants

Abstract

Study Design: A retrospective study. Objectives: Using ultrasound to evaluate association of minor cutaneous stigmas with occult spinal dysraphism (OSD) according to the presence of co-morbidities. Summary of Literature Review: OSD can be associated with various cutaneous markers. Ultrasound of the spine is an effective, noninvasive screening method. Materials and Methods: Over a 5-year period (2009-2013), a total of 180 infants with various skin stigmas were evaluated. Ninetyseven patients were normal infants, eighty-three had other co-morbidities. The type of skin stigmata and/or co-morbidities as well as lumbar ultrasound results were reviewed for all patients. Results: Three of the 97 normal infants had abnormalities. One of the three had OSD. Eighteen of the 83 infants with congenital anomalies had abnormalities, and eleven of the 18 had OSD. Infants with congenital anomalies were 6 times more likely to have OSD than normal infants (OR 5.98, 95% CI 1.927 to 18.612, p=0.001) and there was no significant correlation between the presence of minor skin lesions and the presence of dysraphism. Conclusions: So-called minor skin lesions were not markers of OSD in normal infants. However, because of the feasibility, simplicity, and low cost of spinal ultrasound, the examination is justified by the benefits of early diagnosis.