Bone and meningeal pathology

Bone pathology includes the following three sub items which are

1-Spina bifida(bony defect).

2-Anomalous vertebra.

-Butterfly.

-Hemivertebrae.

-Fused.

3-Sacral agenesis ( caudal regression syndrome). 



 Meningeal pathology includes the following three sub items which are

1-Meningocele.

-Single or multiple.
-If infected---Marginal enhancement.
-Could be arising anterior to the spinal column known as anterior meningocele or arising lateral to it known as lateral meningocele ( common in the thorasic region).

Posterior meningocele

Anterior meningocele

Reference of the image

2-Meningomyelocele.

-Is not covered with skin.

-Contains CSF and neural elements.
-Associated with chiari malformation, hydromyelia and disatematomyelia.

Thorasic meningomyelocele

3-Meningolipomyelocele 

(this can be defined as a subcutaneous lipoma extending through a spinal vertebral defect to reach the canal and connected to another lipoma inside this spinous canal) . 

Saggital T1W MRI showing tethered cord and lumbosacral intradural lipoma extending to huge subcutaneous lipoma at sacrococcygeal level

1-Spina bifida(bony defect is bony pathology ).

 Spina bifida cystica(bony and meningeal pathology):

*Characterized by a back mass covered with the skin and known as spina bifida cystica.
*Could be meningocele if it contains only CSF or meningomyelocele if contains CSF and spinal tissue elements or lipomeningomyelocele if it contains fat in addition to CSF and spinal tissue.

Spina bifida aperta(bony and meningeal pathology):

*Characterized by a back mass but not covered with the skin.

Spina bifida occulta(bony pathology):

*Characterized with no back mass (bony defect with no protrusion of a mass in the back of the patient). 


2-Anomalous vertebra(bony pathology).

-Butterfly vertebra:

 Butterfly vertebrae are thought to result from the failure of fusion of the lateral halves of the vertebral body due to the presence of persistent notochordal tissue between them. 


 -Hemivertebrae:

Large progressive hemi vertebra between T-12 and L-1

Better to be evaluated in the axial view then sagital.

One half of the vertebra is not similar the other half.

-Fused vertebra: 






 3-Sacral agenesis ( caudal regression syndrome):

 Caudal regression syndrome in 3-day-old girl of diabetic mother. Sagittal T1-weighted MR image confirms blunted conus medullaris and associated fat in filum (arrow) as well as absence of sacrum and coccyx (arrowhead).

This syndrome characterized by agenesis of the sacrum and can extend to the lumbar spines, but if reaches the level of D10, it will be incompatible with life. 


With abrupt termination of the conus.