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Fetal Spine Abnormalities - Coggle Diagram

- - - - Minor Bony defect only
      - Failed fusion of posterior elements
      - Dimple in back
      - ≈10% of population
    - - 90% Lumbar or Sacral
      - Spina bifida plus protruding meninges ±cord
      - Difficult to differentiate sonographically
      - Bladder / bowel / mobility problems
      - No skin covering
      - US
        
        Tr
        
        Bone defect splaying post elements
        
        Skin defect
        
        Overlying Sac (Menigessac/ CSF)
        
        Don’t push too hard
        
        Sag
        
        Disruption of bony elements
        
        Posterior cystic mass
        
        +Internal echoes (=neural elements)
        
        Cor
        
        Skin line not seen!
        
        Last Rib = T12 (useful landmark for counting vertebrae to estimate
        level(s) involved)
  - - - Banana Sign (cerebellum) (dumbell shape, vermis intact normally),
      - ↓ Cisterna Magna (<2mm) (too large if -steep angle - dandy walker malformation)
      - Lemon Sign (scalloping frontal bone)
      - Ventriculomegaly
  - - - Must differentiate from BL
      - May have AV shunting
        
        cardiac output > hydrops
        
        Intrauterine surgery to save baby
    - - Caudal Regression Sequence
      - distal neural tube disruption
      - Ass/w DM1
      - Absent lower vertebrae/sacrum
      - Hypoplastic legs
        
        Abnormal position (“Cross-legged tailor” or “ Buddha” pose)
        
        Clubfeet
      - Associated ABN: GI, GU, Cardiac and Arnold Chiari II
    - - Lateral deviation of spine
      - Ass/w
        
        5% isolated (Hemivertebrae)
        
        95%
        
        Limb Body Wall
        
        Amniotic Band Syn.
        
        Spina Bifida
        
        VACTERL