Imaging of Congenital Anomalies of the Spinal Cord: Part 2.

Closed spinal dysraphisms without a subcutaneous mass comprise diverse congenital anomalies arising from disrupted primary or secondary neurulation, often presenting with subtle clinical features yet significant long-term neurologic, orthopedic, and urologic morbidity. Pathophysiology frequently involves intrinsic cord maldevelopment or tethered cord syndrome. Imaging, particularly MR imaging, is central to diagnosis, enabling categorization into simple (eg, intradural lipoma, filum terminale lipoma, and persistent terminal ventricle) and complex lesions (eg, dermal sinus tract, neurenteric cyst, split cord malformation, and segmental spinal dysgenesis). Recognition of embryologic mechanisms and characteristic imaging patterns is critical for accurate diagnosis, risk stratification, and guiding neurosurgical management.