Part 3: examination of the newborn with closed spinal dysraphism.

Spinal dysraphism, an incomplete closure of the neural tube, can be open, exposing the neural elements to the environment, or can be closed, covered with skin. Abnormal development of the spine occurs early in life and also interferes with usual development of the skin. This often creates cutaneous markers or stigmata over the area. Cutaneous markers may include a subcutaneous mass, abnormal hair growth, skin dimple, tag or sinus, or unusual pigmentation. Recognizing these markers is important because, although many closed spinal dysraphisms are asymptomatic at birth, neurological sequelae can occur. The sequelae are insidious and often permanent. This article, Part 3 in a series of articles devoted to spinal assessment, reviews closed spinal dysraphisms. The article emphasizes identification of various cutaneous markers associated with closed spinal dysraphisms. Early detection and follow-up may prevent neurologic sequelae for the infant later in life.