Occult dysraphism of the spine. A retrospective analysis of 88 operative cases, 1979-1989.

Eighty-eight children under the age of 12 years with occult spinal dysraphism were operated on at Red Cross War Memorial Children's Hospital from 1979 to 1989. There were 56 lumbosacral lipomas, 18 dermal sinuses and cysts, 7 isolated thickened filum terminales and 7 diastematomyelias. The incidence of neurological abnormality was significantly higher in children operated on after 12 months of age (15% v. 60%). At surgery the commonest variant of the lumbosacral lipoma was the dorsal type. The incidence of postoperative complications was low (CSF leak 10%; superficial infection 6%). Three children improved neurologically, but the vast majority remained unchanged. The desirability and safety of early prophylactic surgery for occult spinal dysraphism is supported by this study.