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Spina BifidaProtocol

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Spina Bifida Protocol • obtain coronal or parasagittaland number bony elements

• number bony elements either by starting at the bottom of the spine (S5) and count upwards as demonstrated above

OR• start at the last rib (T12) and count downwards

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Spina Bifida Protocol• transverse: last normal level• transverse: first abnormal level

demonstrating splayed element down to end of defect

• image whether skin covered or not; bony elements may appear splayed beyond non-skin covered elements

• obtain 3d images whenever possible (surface rendering / multi-planar views)

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Level at which defect begins (L5-S1)

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S1 S1

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S2S2

Sac in 3D

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S3 S3

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S4S4

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S5 S5

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(3Ds)

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Sequential views of defect – be sure to include the level above splayed level…

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Document the following:

• cerebellar displacement• cisterna magna (obliteration)• cortical mantle thickness (frontal

region)• lateral ventricles (measure)• hip, knee, ankle, toe movement

(videotape)• feet (clubbing, no clubbing)

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Measurement of lateral cerebral ventricles and dangling choroid

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Dangling choroid plexus

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Dangling choroid plexus

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Cerebellum with obliteration of the cisterna magna

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