Spina Bifida Differential Diagnoses

Updated: Sep 22, 2016
  • Author: Mark R Foster, MD, PhD, FACS; Chief Editor: Elizabeth A Moberg-Wolff, MD  more...
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DDx

Diagnostic Considerations

Meningocele and myelomeningocele must be differentiated. Meningocele is the herniated protrusion of only the meninges through a defect in the cranium or vertebral column. This lesion does not contain neural tissue in the sac.

Spina bifida occulta is a common radiographic finding characterized by simple lack of fusion of vertebral spinous processes. The spinal cord itself is normal.

Tethered spinal cord

As previously mentioned, the diagnosis of tethered cord syndrome is confirmed on the basis of clinical signs and symptoms, which can include pain, sensory changes, spasticity, and progressive scoliosis.

However, uncontrolled hydrocephalus and Chiari II malformation must be excluded as causes of these symptoms. Moreover, symptoms similar to those of tethered cord syndrome can also be caused by other intraspinal pathologies, such as the following:

  • Mass lesions of the cord
  • Diastematomyelia
  • Cord cavitation and narrowing
  • Adhesions
  • Dural bands