The neonatal spine: Ultrasound technique and pathology
The neonatal spine: Ultrasound technique and pathology, Mariesa Taylor-Allkins, Fariba Williams, Roy Wheeler, Tom Watson, Great Ormond Street Hospital for Children, London
Learning Objectives:
We present an educational poster of ultrasound scanning techniques and imaging examples of both normal and abnormal neonatal spinal pathology encountered at a quaternary paediatric referral centre.
Background:
Great Ormond Street NHS hospital, London (GOSH) is a quaternary paediatric referral centre which sees a wide variety of patients and pathologies. Ultrasound is frequently used at GOSH as a first line investigation of the spine and is particularly useful as a screening tool for most suspected neonatal spine abnormalities within the first few hours of life. It is an effective, non-invasive technique with high sensitivity and specificity. The pitfalls however, are that it is highly operator dependent and requires a sound knowledge, systematic approach and confidence in usage of the equipment.
Findings:
We analysed imaging of patients referred to our institution over the last 5 years (which included 300 patients) for an ultrasound of their spine in order to:
• Present our ultrasound scanning techniques and protocols used to enhance imaging and reduce inter-observer variability.
• Highlight the variety of clinical presentations requiring specialist spinal imaging that lead to a quaternary centre referral. These commonly include abnormalities seen in utero, myelomengocoele, skin discolouration of the lumbar region, sacral dimpling, bladder abnormalities and congenital abnormalities with spine association.
• Present a pictorial review of the variety of pathology encountered using ultrasound alongside any cross sectional imaging correlates, drawing reference from normal anatomy. These include myelomeningocoele, cord tethering, sacrococcygeal teratoma and vertebral anomalies
Summary:
Spinal pathology is a commonly encountered entity however often met with a degree of trepidation when ultrasound is used as an imaging modality. We have shown the techniques employed at a quaternary paediatric centre alongside both normal anatomy and examples of pathology with cross-sectional imaging correlates.