Evaluation Of Spina Bifida Occulta In Young Patients Presented With Low Back Pain
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 10, Pages 4416-4422
AbstractIntroduction :Spina bifida occulta is a condition arising during neurological development as a result from neural tube failing to close, it was a widespread with I the lumbo-sacral spine. The lesion is present at birth and the incidence of SBO decrease with age, it can be associated with many congenital disorders like intraspinallipoma, tethered cord syndrome and genitourinary dysfunction. Prevalence of SBO is related to various factors such as genetic predisposition , environmental factors and drugs.
Methodology : This was a descriptive study of young patients with low back pain diagnosed as spina bifida occulta, the duration of the study 2 years, 80 patients were selected ho complaining from low back pain with or without neurological signs for at least 4 weeks. All patients evaluated with standard lumbo-sacral X- rays ad patients with neurological signs evaluated with lumber vertebra magnetic resonance images (MRI) and all these images evaluated by Radiologist according to the 2001 standard of the North American Spine Society. The bone defect divided into 3 groups, group 1 with incomplete SBO in one level, group 2 incomplete SBO in two adjacent vertebra and group 3 , complete SBO involving all posterior arch.
Results :Of the 180 study patients . 35 % female and 65 % male. The age range was 15-35 years , 91.1 % without neurological signs while 8,8% with neurological signs. SBO most commonly observed at L 5 ( 45.4 %). Patients with or without neurological deficit or signs showed no correlation for the presence of single or multiple level of SBO, but significant difference was observed between these groups for disc prolapse in CT and MRI.
Conclusion : Presence of SBO should always think in young patients with a pain with or without neurological signs. A thorough evaluation is required to identify the causes of LBP which includes a detailed history, physical and neurological examination and radiological imaging to confirm the diagnosis.
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