SPINA BIFIDA OCCULTA – WHAT IS ITS SIGNIFICANCE?


The two cases presented here demonstrate the benign presentation of spina bifida occulta. There is a benign spina bifida occulta affecting the C7, T1 and T2 segments without evidence of block vertebrae or congenital fusion. In the cervical spine most cases of spina bifida occulta are not symptom generating and are not associated with any other abnormalities. However, if spina bifida occulta should occur at C5 or C6 as an isolated entity it may be associated with true cervical spondylolisthesis with lack of development of the pars–lamina area. The additional case here demonstrates spina bifida occulta at L5 which carries a higher incidence of an association with pars defects and/or spondylolisthesis. Many patients with benign spina bifida occulta at L5 do not have spondylolisthesis but many do. So, when viewing spina bifida occulta at L5, one should always look very closely for defects in the pars and if necessary, obtain oblique radiographs to rule out a pars interarticularis defect.

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