ABSTRACT
Imaging techniques suggesting a neurogenic etiology Lumbosacral spine X-rays Lower urinary tract (LUT) dysfunction in children, and more rarely in young adults, can be the expression of an underlying spinal dysraphism. In the majority of cases, abnormalities of the gluteosacral region and/or legs and foot are visible (e.g. small dimples, tufts of hair, subcutaneous lipoma, dermal vascular malformations, one leg shortness, high arched foot or feet). However, in some cases these abnormalities may be minimal or absent. A careful evaluation of the anteroposterior and lateral film of the lumbosacral spine can identify vertebral anomalies commonly associated with nervous system anomalies.1-5
Sacral agenesis involves the congenital absence of part or all of two or more sacral vertebrae. The absence of two or more sacral vertebrae always implies the presence of a neurogenic bladder dysfunction (Figures 6.1 and 6.2).6,7
The significance of spina bifida occulta can vary. Simple failure to fuse the laminae of the 4th and 5th lumbar vertebrae is unlikely to be important, but when the spinal canal
is noticeably widened, there may be cord involvement (diastematomyelia, tethered cord syndrome).8
