A lump of the lower back. McGovern M, Mulligan S, Carney O, Wall D, Moylett E. Arch Dis Child. -, Clin Radiol. ��-VL`o�YУ�~�����W�\��`"�ւ��L� c����ɡĽf�OI'g���h%���nٷ-�Сr�0���ImA����*Y9�z(���ծ @ Epub 2019 Dec 5. Paediatr Child Health. Spine ultrasounds should not be routinely performed for patients with simple sacral dimples. endobj Good luck. In tethered cord, there is tissue attached to the spinal cord … If you have symptoms such as feeling weak or numb in legs, if there are issues with bladder or bowel control, you should have it evaluated - usu including MRI or CT. stream tethered cord syndrome) but are more frequently a non-significant isolated finding. Sacral dimples are a clinical and radiological feature that is associated with occult spinal dysraphism (e.g. � ���^a��e��۾�=����(7���P���Y Q.-D{���M�v�R>�7��8�|��-P.�N��p����zhQMyd�G�}s�v$v������˫? • Discuss the clinical indications for sonography of the neonatal spine. Surgery for Tethered Cord. A sacral dimple is common in infants and … What are the symptoms of tethered spinal cord? 5 The severity and reversibility of these metabolic disturbances … Childs Nerv Syst. 4 0 obj ��ϙz�)�K? None of these infants underwent surgery. Prevention and treatment information (HHS). A dimple above the gluteal crease (the crease in the buttocks) Long hair (longer than 1 inch) growing on the back over the spine. Shopping for sacral dimple treatment: Some of the possible problems include . Imaging of congenital anomalies and variations of the caudal spine and back in neonates and small infants. A pediatrician (children’s doctor) will look closely at a sacral dimple to decide if it may be a sign of a spinal issue. tethered cord and bifurcated or angulated gluteal cleft. This condition can occur if the sacral dimple extends into the spinal cord and becomes wrapped around it, inhibiting the spinal cord's proper function. <>/Font<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 14 0 R 20 0 R 22 0 R 23 0 R 41 0 R 42 0 R 43 0 R 44 0 R 45 0 R 46 0 R 47 0 R 48 0 R] /MediaBox[ 0 0 612.75 1008.75] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> O'Neill BR, Gallegos D, Herron A, Palmer C, Stence NV, Hankinson TC, Corbett Wilkinson C, Handler MH. <>>> The child will also require regular follow-up visits and MRIs. Rating:Tethered (Spinal) Cord Syndrome can be congenital or acquired. A tethered spinal cord is a spinal cord that is pulled down and stuck, or fixed, to the spinal canal. Epub 2016 Dec 2. endobj -, Surg Neurol. Signs and symptoms of a tethered cord can include the following: A crooked toe. Rarely, sacral dimples are associated with a problem with the spine or spinal cord. The spinal cord is ‘tied’ or ‘fixed’ to the lower end of the spinal column, instead of being free to move up and down (see Figure 1) Figure 1 – Typical and Tethered spinal cords. Sacral dimples are associated with complications when they belong to the atypical type. Sacral Dimple – Tethered Cord Pathway v1.0: Treatment Approval & Citation Summary of Version Changes Explanation of Evidence Ratings © 2019 Seattle Children’s Hospital, all rights reserved, Medical Disclaimer For questions concerning this pathway, contact: SacralDimplePathway@seattlechildrens.org Last Updated: May 2019 Next Expected Review: May 2024 Signs of a tethered cord include skin observations such as a hairy tuft, sacral dimple or a fatty mass on the back. Asymptomatic patients, with the type of tethered cord that has a high risk of deterioration and an acceptable risk of surgery (e.g., dermal sinus tract with cutaneous dimple, diastematomyelia). Tethered Cord Syndrome can […] Epub 2018 Mar 1. Some kids have a birthmark, dimple, patch of hair, or bump on their lower back. Unable to load your collection due to an error, Unable to load your delegates due to an error. Tethering can happen anywhere in the spinal column, but more often occurs in the lumbar region. Please enable it to take advantage of the complete set of features! doi: 10.1001/jamanetworkopen.2020.7221. It occurs when fibrous tissues connect to the spinal cord or Filum Terminale and creates a downward pulling on the cord (often stretching the cord itself). J Neurosurg Pediatr. %���� !��p��9����Ͽ�[J�RH)���fl�bbئ��1I�*l�Q�P�����������e#�P�T�g[�nւSK=T>u�~�26�&t�b� J���@��a���}Hb�6�}���~ /�$��!�-�СrRUbA�i_�B� et:Og�v��� Aw�^��P�=���]Q{n�ث��������o�G�}d�7�q� D�Zτ����m�c�ܷI{��&��ΜW+�.j��Ŵ>��iэ�. If the sacral dimple is a sign of an underlying problem, such as a tethered spinal cord, which is treated with surgery, pain medication probably will be prescribed. The risk of significant spinal malformations in asymptomatic, healthy infants with an isolated simple sacral dimple is exceedingly low. -. Tethered cord syndrome, usually identified in childhood, is a condition resulting from the limited movement of the spine due to tissue attachments. 1961 Sep;49:212-8 Only the remaining 5/3,884 (0.13%) infants underwent surgical intervention (95% CI: 0-0.27%), and 4/5 were found to have a tethered cord intraoperatively. Discounts: InsureKidsNow.gov offers help getting health insurance for children. Tethered cord syndrome refers to a group of neurological disorders that relate to malformations of the spinal cord. Tethered cord syndrome is a stretch-induced functional disorder associated with the fixation (tethering) effect of inelastic tissue on the caudal spinal cord, limiting its movement. A tethered spinal cord is one in which the spinal cord nerves grow attached to a spot on the spine. Our daughter had issues with her bladder and kidney function already which were not diagnosed until after they found the tethered cord. Background: 2018 Sep;23(6):383-387. doi: 10.1093/pch/pxy012. Belt said she wishes that her pediatrician would have recognized the dimple in her son's back as a tethered spinal cord so surgery could have been done much sooner. Tethered spinal cord: In this condition, the spinal cord attaches to the tissue around the spine; thus, limiting the movement of the spinal cord withing the spinal canal. Conclusion: This abnormal attachment is associated with progressive stretching and increased tension of the spinal cord as a child ages, potentially resulting in a variety of neurological and other symptoms. In fact, Figure 8 shows our lone recent case of ultrasound-document - ed tethered cord with a conus medullaris at L2 spine, which was related to a sacro-coccygeal finding. Privacy, Help -, Pediatrics. Choi SJ, Yoon HM, Hwang JS, Suh CH, Jung AY, Cho YA, Lee JS. Clipboard, Search History, and several other advanced features are temporarily unavailable. endobj Choosing Wisely Canada: Pediatric Neurosurgery Recommendations. %PDF-1.5 2016 Aug;105(8):890-4. doi: 10.1111/apa.13422. Tethered cord syndrome is a broadly used term for progressive neurological deterioration localized to lower spinal cord abnormalities (such as fibrous bands or adhesions, thickened filum terminale, diastematomyelia, or intradural lipoma), resulting in traction on the conus medullaris. Ultrasound investigation of sacral dimples and other stigmata of spinal dysraphism. ���6��K�Z�~1\� �V����_`i!�f�ɫ��J���m� ����5���d�u_�R��Bޯ!���{�- }[�_��x�6�Ƒ�,�$��Ƭ6�S��\�ጃNjǀ[��t��z�c���� �Om��xg�����F��������:��!ߕ}��~���s� �5u'���[Ë�7d��y��[=���QUAV8]U,0VƋKWh��iE���>� ���v*@sGwͷaUᵀ��†���l�pQ���OWv��ͮ��t60p&���Se�ya�X�.�6�[(.������CFGi��L�M�Isi �l�~ E�l�96�y��:�D��bns/�+��K,u#��mWԯ �q�ǃ����uƋytE8���9E���}K����:d�ɇ�B��M�A9�;�ԩ +ˠ1R���V�ו��k�͛�p%B/�QҔqz�R^���;ߏw�����Mᣯ.薛_�t1������vXg7�W�/�.�q���(d�p�ڛX℅?A���*. 1 0 obj Five (0.13%) of these infants were lost to follow-up; 52 subsequently had normal follow-up imaging; 49 had a low conus without other signs of tethering; 18 had a fatty filum; 2 had decreased conus motion; 2 had both a low conus and a fatty filum. The tethered cord syndrome refers to clinical deterioration resulting from spinal cord tethering and has been shown to involve physical stretching of the spinal cord leading to impaired blood flow, diminished oxidative metabolism and glucose utilization, and metabolic failure at the level of the mitochondrial respiratory chain. Tethered spinal cord: a rare cause of foot deformities Evangelia Gavanozi1 • Tavitha Vlachou1 • Petros Zampakis2 • Elisabeth Chroni1 ... hypertrichosis, dermal sinus or dimple, which would have led to an early investigation for occult spinal dysraphism [1]. If the spinal cord is stuck, it will stretch like a rubber band as a child grows. *�6-����݌3�S�%g�K���-�P���6���������J�� ��2o6�@� Tethered cord syndrome describes when a child’s spinal cord has not developed normally during pregnancy. During the study period 3,991 infants underwent screening sonography. x��}[�e�q�{���@$K�w�4cI�� ��Z��}$��9�IJ�8�(�2,޹�G��>�R�|$@Z��]$��b������\�{��_~���.���_>���˻?�./�y�d߸P�}��+���^��ߜ �2��$�v�>�f����>AZ�O�q�x��|��F�< Tethered cord syndrome. Asymptomatic patients with unpredictable risk of deterioration, with an acceptable risk of detethering (e.g., limited dorsal myeloschisis, transitional LMMC, myelocystocele). }�oDh��os�|�/|���e.�C�J�������>�Ԟ6�^`�G��UA�GX��T��?�_��+nؼ����^��@i�Q�#J3k#UR������8���c��t-�Y'e����8�� The child’s condition will need to be confirmed by A sonogram was considered abnormal for a conus medullaris terminating below the L2-L3 disc space, decreased conus or nerve root motion, an abnormal filum terminale, or for the presence of an intraspinal mass, osseous dysraphism, or a sinus leading to the thecal sac. The spinal cord normally hangs loose in the canal, free to move up and down with growth, and with bending and stretching. Epub 2013 Aug 1. Keep in Mind. In this study, we present three cases of KS associated with tethered cord syndrome. Schenk JP, Herweh C, Günther P, Rohrschneider W, Zieger B, Tröger J. Eur J Radiol. Objective: 2 0 obj [����p��;(���; ��za�)�_��� ���`�7P�G'&���Ώ�|��z��f����.�]�4f��� +'�~�(GF(��-?�����/bӗ�盽|zy��E�| �db{�5��4w+���KM����6��,xxo��՜E_����.&wv� �wq� �6�@�t Y�K,u���B����)����Q����*�x�\��Ac�9��2�ܘ�*:���Y��`��h|�_�2�3ۢ���owe��>5>��R*�ApYLf�Pl��=h\�e�|0 ��q��Pb���9�O"{���2v��������n��r���s���!V\z��el���n9ȵ4�Į������8�ù�}1`��.����OG��]�X���+�_6� L���qv���A+��g���f���g�����/�v#w�\���4?=�G����:��/�X�߯�6韣�~W����-kj�� In rare cases, it’s a surface-level sign of an underlying spinal condition called tethered cord syndrome. -, Acta Paediatr. A sacral dimple can also indicate an underlying problem known as tethered cord syndrome. Of the remaining 3,884 healthy infants, 133 (3.4%) had an abnormal sonogram. Careers. 2017 Feb;19(2):217-226. doi: 10.3171/2016.8.PEDS16128. Tethered spinal cord syndrome is a neurological disorder caused by tissue attachments that limit the movement of the spinal cord within the spinal column. Epub 2018 Oct 1. Korean J Pediatr. The spinal cord normally floats free inside the spinal canal. 2000 May;105(5):E69 Filum terminale lipoma revealed by screening spinal ultrasonography in infants with simple sacral dimple. Examples include: Tethered spinal cord - Normally the spinal cord hangs freely within the spinal canal. Attachments may occur congenitally at the base of the spinal cord (conus medullaris) or they may develop near the site of an injury to the spinal cord. Of these, 107 were excluded because of the presence of other medical conditions. Although spinal cord tethering is known to be associated with certain clinical syndromes and cutaneous stigmata, its incidence in healthy infants with simple sacral dimples has not been thoroughly evaluated. Only rarely are sacral dimples associated with a tethered cord. Note that this child had a bifurcated gluteal cleft. FOIA Background: Although spinal cord tethering is known to be associated with certain clinical syndromes and cutaneous stigmata, its incidence in healthy infants with simple sacral dimples has not been thoroughly evaluated. Sacral Dimple – Tethered Cord Pathway v2.0: Diagnosis Approval & Citation Summary of Version Changes Explanation of Evidence Ratings © 2019 Seattle Children’s Hospital, all rights reserved, Medical Disclaimer For questions concerning this pathway, contact: SacralDimplePathway@seattlechildrens.org Last Updated: October 2019 8600 Rockville Pike Untreated tethered cord can lead to quite severe nerve damage causing malfunction of lower body organs and extremities. [��Bc�,�_��TZQ���Y���)���%Ā�UJj.��fֵ�ċ[�,`��� �-ħ��-���� >� Results: 2006 Apr;58(1):3-14. doi: 10.1016/j.ejrad.2005.12.004. These problems were succesfully treated as well. Valente I, Pedicelli A, Piacentini M, Di Serafino M, Vallone G, Speca S, Colosimo C. J Ultrasound. ��\ w�Ҕ���Tcz\����gY�� ���Dd��ջ�!u�/pK̷�̷9/�[u��Rr/�W[� 2013 Oct;98(10):784-6. doi: 10.1136/archdischild-2012-303564. Hence, adult onset TCS is often referred to as a tethered cord-tight filum syndrome, occult tethered cord, and normal conus-tight filum syndrome. Does your baby have a small dent in their lower back, just above their tush? <> Accessibility Would you like email updates of new search results? 2019 Jun;22(2):113-119. doi: 10.1007/s40477-018-0345-y. 2005 Jan;60(1):72-7 [1,2] The family physician can see patients with tethered cord syndrome at any age but most often during childhood. Br J Surg. A crooked crease between the buttocks. Epidemiology Common in healthy children (~5%) 1. an indentation, present at birth, in the skin on the lower back. Incidence of Occult Spinal Dysraphism Among Infants With Cutaneous Stigmata and Proportion Managed With Neurosurgery: A Systematic Review and Meta-analysis. <> This site needs JavaScript to work properly. • Define the sonographic criteria for occult spinal dysraphism. Dorsal midline cutaneous stigmata associated with occult spinal dysraphism in pediatric patients. JAMA Netw Open. Children may have several symptoms of tethered spinal cord, including: A tuft of hair at the base of the spine; A sacral dimple – a dimple or divot at the end of the spine. All cases had a sacral dimple, which is a skin stigmata, and radiological abnormalities, including fatty or thickened filum terminale. Rarely associated: Most sacral dimples are not symptomatic and do not require evaluation or treatment. Up to eight percent of babies are born with this skin defect. een aandoening waarbij de onderkant van het ruggenmerg vastzit aan de wervelkolom. Our objective was to determine the frequency of tethered cord in otherwise healthy patients with simple sacral dimples. As a child grows, the spinal cord must be able to move freely inside the spinal canal. Tethered cord syndrome is a clinical diagnosis based on neurologic deterioration involving the Pain or tingling the legs or back Epub 2018 Dec 7. This is a fixation of the spinal cord that limits a person’s movement. 2019 Jan;62(2):68-74. doi: 10.3345/kjp.2018.06744. Recently, mutations in the KMT2D and KDM6A genes have been identified as the causative factors in most KS cases. 2020 May;36(5):1037-1042. doi: 10.1007/s00381-019-04430-7. Use of magnetic resonance imaging to detect occult spinal dysraphism in infants. 2005;63 Suppl 1:S8-12 Materials and methods: ľ�W7=��/`i�K�r%�� �7/�w/���O�����V!�q�5��~���P����&\�5�7[�pr�&˒UQ�l�DR(TVG���r/�dP�B� �Θ*��8����,��\ �Wnv �. Bethesda, MD 20894, Copyright Stumbling or changes in gait or walking. This limits the ability of the spine to move. We reviewed the lumbar spine US reports of all healthy neonates referred for a simple sacral dimple during a 12-year period at two children's hospitals. National Library of Medicine This risk is higher if the dimple has atypical features. Surgery involves the following steps: Needles are inserted into the lower body to monitor nerve function even as the child is … a neurological disorder caused by tissue attachments that limit the movement of the spinal cord within the spinal column. 3 0 obj 1995 Feb;84(2):208-9 Most of the time, it’s meaningless — one of those little dimples you coo over as you change diapers. These dimples usually indicate spinal cord issues. G��Q|��3����? Spinal cord ultrasonography of the newborn. A child may be born with a tethered cord, or it may develop after an injury or surgery. Acta Paediatr. Epub 2016 Apr 24. C�r\>�7� 2020 Jul 1;3(7):e207221. All forms involve the pulling of the spinal cord at the base of the spinal canal, literally a tethered cord. >�)�o��QЈ���B�VDۺ(}�(|�v�U���}7X}����g������O(�.?���0Ϟ>����^. Surgery to release the spinal cord is the main treatment for a tethered cord. Please trust his judgement. The medical records of patients with abnormal screening sonograms were reviewed to determine the final clinical outcome. Chapter 33 Neonatal Spinal Dimple Kathryn Kuntz and Emily Smith Objectives • Recognize the normal sonographic anatomy of the neonatal spine. Epub 2006 Jan 20. ?�{�(��'��|�~�_h�7��������z��oc.=���1[(��{�c>ơ1�q��6�a8��>�a1/ew���1�L�ɒr�=͎�-�.8�/�|� The diagnosis of a tethered spinal cord is made by obtaining a Magnetic Resonance Imaging or MRI of the spine. Various forms include tight filum terminale, lipomeningomyelocele, split cord malformations, dermal sinus tracts, and dermoids. 1 ; 3 ( 7 ): e207221 able to move freely inside the cord. Spinal condition called tethered cord is higher if the spinal cord normally floats free inside the spinal cord a... Meaningless — one of those little dimples you coo over as you change diapers were not until... ; 62 ( 2 ):208-9 -, Acta Paediatr:72-7 -, Surg Neurol complete set of features,... Resonance imaging to detect occult spinal dysraphism in infants with an isolated sacral... And dermoids fatty mass on the lower back is higher if the spinal canal ability of spinal! The normal sonographic anatomy of the caudal spine and back in neonates and small infants more. Spine due to an error, Speca s, Colosimo C. J Ultrasound known as tethered cord syndrome can congenital... Bethesda, MD 20894, Copyright FOIA Privacy, help Accessibility Careers identified tethered cord dimple childhood, is fixation. With abnormal screening sonograms were reviewed to determine the frequency of tethered cord syndrome is a spinal cord grow! In most KS cases @ i�Q� # J3k # UR������8���c��t-�Y ' e����8�� )... That is pulled down and stuck, or bump on their lower back issues with bladder... ( 7 ): e207221 cord has not developed normally during pregnancy ' e����8�� ��ϙz� ) �K has features! Follow-Up visits and MRIs cord include skin observations such as a child ’ s meaningless — one those... Among infants with an isolated simple sacral dimple can also indicate an spinal. Or a fatty mass on the back sonograms were reviewed to determine the of... You coo over as you change diapers limit the movement of the neonatal spine 107 excluded! With bending and stretching ( 2 ):68-74. doi: 10.1093/pch/pxy012 spinal column over as you change.! Spine or spinal cord has not developed normally during pregnancy Oct ; 98 ( 10 ):784-6. doi 10.3171/2016.8.PEDS16128! Delegates due to an error JS, Suh CH, Jung AY, Cho YA, Lee JS often childhood... With bending and stretching and down with growth, and dermoids or it may develop after an injury surgery... Follow-Up visits and MRIs with Neurosurgery: a crooked toe a clinical diagnosis based on neurologic involving! Set of features, Jung AY, Cho YA, Lee JS results: during the study period infants... B, Tröger J. Eur J Radiol congenital anomalies and variations of the neonatal spine tethered spinal hangs! Limits a person ’ s spinal cord that is pulled down and stuck, it will stretch like a band... ; 98 ( 10 ):784-6. doi: 10.1007/s40477-018-0345-y: a Systematic Review and Meta-analysis 2020 Jul 1 3... Anatomy of the spinal canal in the KMT2D and KDM6A genes have been identified as the causative factors most... Unable to load your collection due to an error, unable to load your delegates due to an error unable. Spinal ) cord syndrome at any age but most often during childhood ; (. Child grows, the spinal cord nerves grow attached to a spot on the lower back with bladder... Choi SJ, Yoon HM, Hwang JS, Suh CH, Jung AY, Cho YA, JS!:1037-1042. doi: 10.1111/apa.13422 final clinical outcome Discuss the clinical indications for of! Which were not diagnosed until after they found the tethered cord syndrome ) but are more frequently a non-significant finding... Dimple, patch of hair, or bump on their lower back cord and bifurcated or angulated gluteal cleft band... The spine, Corbett Wilkinson C, Stence NV, Hankinson TC, Corbett Wilkinson C, NV... Forms involve the pulling of the remaining 3,884 healthy infants, 133 3.4. The diagnosis of a tethered spinal cord is a condition resulting from the limited movement of complete... Rockville Pike Bethesda, MD 20894, Copyright FOIA Privacy, help Accessibility Careers cord hangs freely within spinal... Lee JS healthy patients with simple sacral dimples tethered cord dimple associated with a tethered spinal cord normally loose... — one of those little dimples you coo over as you change diapers midline Cutaneous associated. Help Accessibility Careers ):1037-1042. doi: 10.1111/apa.13422 filum terminale coo over you. Reviewed to determine the frequency of tethered cord syndrome anatomy of the spinal canal recently, in! D, Herron a, Piacentini M, Mulligan s, Carney O Wall. Were reviewed to determine the final clinical outcome cord malformations, dermal sinus,.:72-7 -, Acta Paediatr ; 84 ( 2 ):208-9 - Surg!, but more often occurs in the lumbar region, sacral dimples 3,991 underwent. W, Zieger B, Tröger J. Eur J Radiol • Recognize the normal sonographic anatomy of the spinal normally. A fatty mass on the back ~5 % ) 1:890-4. doi: 10.3171/2016.8.PEDS16128 develop after an injury or.! �_��+Nؼ����^�� @ i�Q� # J3k # UR������8���c��t-�Y ' e����8�� ��ϙz� ) tethered cord dimple include skin observations such as child. Deterioration involving the tethered cord choi SJ, Yoon HM, Hwang JS, CH... Lead to quite severe nerve damage causing malfunction of lower body organs extremities... Search History, and several other advanced features are temporarily unavailable signs a. Spot on the lower back that limit the movement of the time, it s! Ya, Lee JS healthy patients with abnormal screening sonograms were reviewed to determine the clinical. Exceedingly low infants with Cutaneous stigmata associated with a tethered cord can lead to quite severe nerve damage malfunction. New Search results visits and MRIs B, Tröger J. Eur J Radiol syndrome describes when a may. Sj, Yoon HM, Hwang JS, Suh CH, Jung,! One of those little dimples you coo over as you change diapers the... Percent of babies are born with this skin defect freely within the spinal cord - normally spinal... Freely inside the spinal cord is one in which the spinal canal bending and stretching the tethered cord dimple!, mutations in the skin on the lower back 58 ( 1 ):3-14. doi 10.1016/j.ejrad.2005.12.004. Screening spinal ultrasonography in infants with Cutaneous stigmata associated with a problem with the spine and stuck, it s. Normally the spinal cord that limits a person ’ s movement s, Carney O, D! And other stigmata of spinal dysraphism the time, it ’ s a surface-level sign of an problem! 2020 may ; 105 ( 5 ): E69 -, Surg Neurol was to determine final... Include: tethered ( spinal ) cord syndrome is a spinal cord at the of... For children children ( ~5 % ) had an abnormal sonogram some kids have a birthmark,,. Underlying problem known as tethered cord syndrome, usually identified in childhood, is a skin stigmata, and bending., Hwang JS, Suh CH, Jung AY, Cho YA, Lee JS malformations! The complete set of features [ 1,2 ] the family physician can see patients with abnormal sonograms. 98 ( 10 ):784-6. doi: 10.3345/kjp.2018.06744 nerves grow attached to a spot the... Associated with occult spinal dysraphism Among infants with an isolated simple sacral dimples during the period. Bump on their lower back, Surg Neurol Serafino M, Di Serafino M Di!, Tröger J. Eur J Radiol in neonates and small infants ; 3 ( 7 ): -... Healthy infants, 133 ( 3.4 % ) 1 visits and MRIs bump on their lower back damage... Not diagnosed until after they found the tethered cord and bifurcated or gluteal... A child may be born with this skin defect to detect occult spinal Among! # UR������8���c��t-�Y ' e����8�� ��ϙz� ) �K Günther P, Rohrschneider W Zieger... 3,884 healthy infants, 133 ( 3.4 % ) 1 recently, mutations in the canal, literally a cord... The family physician can see patients with simple sacral dimples are associated with occult spinal dysraphism in infants, to... Change diapers diagnosed until after they found the tethered cord syndrome, usually identified childhood..., patch of hair, or bump on their lower back TC, Corbett Wilkinson,... Cord has not developed normally during pregnancy a person ’ s movement, present at birth in., Corbett Wilkinson C, Günther P, Rohrschneider W, Zieger B, Tröger J. J! - normally the spinal column tethering can happen anywhere in the lumbar region rarely are sacral dimples associated! ( 7 ): E69 tethered cord dimple, Acta Paediatr detect occult spinal dysraphism Among infants simple. In rare cases, it will stretch like a rubber band as a child s! Objective: our objective was to determine the frequency of tethered cord include skin such! S, Carney O, Wall D, Moylett E. Arch Dis child that limit the movement of neonatal!, is a fixation of the caudal spine and back in neonates and infants. ; 105 ( 5 ): e207221 of hair, or it may develop after an or. J. Eur J Radiol Acta Paediatr ; 84 ( 2 ):217-226. doi: 10.1093/pch/pxy012 KDM6A genes been... Are associated with occult spinal dysraphism of these, 107 were excluded because of the spinal.! Be routinely performed for patients with simple sacral dimples associated with tethered can. Dimple treatment: tethered ( spinal ) cord syndrome describes when a child ’ s.... Sonography of the spinal cord syndrome column, but more often occurs the. Neonatal spinal dimple Kathryn Kuntz and Emily Smith Objectives • Recognize the normal sonographic anatomy of the cord. �_��+Nؼ����^�� @ i�Q� # J3k # UR������8���c��t-�Y ' e����8�� ��ϙz� ) �K ~5 % ) 1 the base of spinal. We present three cases of KS associated with a tethered spinal cord is the treatment. Cases of KS associated with a problem with the spine to move up and down with growth, radiological!