Differential Diagnosis (Minimal Spinal Dysraphism)

Diagrammatic drawings of the dysraphic malformations which are recognizable from the outside according to M. Bettex. A) The spinal cord is normal and lies in the spinal channel (6). Bag-like continuation of the arachnoid underneath the normal skin (3). B) The spinal cord is malformed and lies abnormally in the spinal channel (6). Over the malformed spinal cord and in connection with it a lipoma is spreading out underneath the skin (7). C) The spinal cord is malformed, lies outside the spinal cord, and is not covered by skin at the level of the surroundings (6). The arachnoid inserts at the borders of the exposed spinal cord (2). A) Meningocele; B) Myelomeningocele with lipoma; C) Myelomeningocele. There are several variants of these clear drawings. For instance, the arachnoid may continue within a lipoma like a bag. Or, depending on the degree of filling of the subarachnoid space with CSF under pressure, the myelomeningocele is protruding more or less. See pictures for comparison ($$turu_12??nr=2££alternate figure 1§§ and $$turu_13??nr=2££alternate figure 2§§). Or, the myelomeningocele may be epithelizied to different degrees. A connection with the fourth ventricle exists by the central channel which is open in spina bifida, or, if there is a rupture of the arachnoid, there is a communication with the subarachnoid space of the spinal channel.