Congenital spinal disorders are conditions that develop before birth and affect the formation of the spine, spinal cord, nerves, or surrounding tissues.
Some congenital conditions are discovered during infancy or childhood. Others remain unnoticed until adolescence or adulthood, when they begin causing pain, weakness, numbness, spinal deformity, or difficulty walking.
The severity varies widely. Some patients need only observation, while others may require treatment to protect the spinal cord, correct instability, or prevent worsening deformity.
Major Diagnosis Types
Below are the major types we see in our clinic. Click on available links to learn about our approach to the problems.
Chiari Malformation
Chiari malformation occurs when part of the cerebellum extends downward through the opening at the bottom of the skull.
Although it involves the connection between the brain and spine, it is often evaluated and treated by a neurosurgeon.
Symptoms may include:
- Headaches
- Neck pain
- Dizziness
- Balance problems
- Numbness
- Weakness
- Difficulty swallowing
- Syringomyelia
Minor Diagnosis Types
These terms are often encountered, but are either less often treated or described within one of the above diagnoses.
Block Vertebra
A block vertebra occurs when two or more vertebrae fail to separate normally and remain joined together.
Many block vertebrae cause no symptoms.
In some patients, the abnormal segment changes spinal mechanics and increases stress on the levels above and below.
Congenital Cervical Instability
Some congenital conditions affect the upper cervical spine and create abnormal movement between the skull, first cervical vertebra, and second cervical vertebra.
Instability may compress the spinal cord and cause weakness, balance problems, or loss of coordination.
Congenital Kyphosis
Congenital kyphosis is an abnormal forward curvature caused by improper formation or separation of the vertebrae.
This condition can sometimes progress rapidly and may place the spinal cord at risk.
Symptoms may include:
- Rounded posture
- Back pain
- Progressive deformity
- Weakness
- Difficulty walking
Congenital Scoliosis
Congenital scoliosis is a sideways spinal curvature caused by abnormal formation of one or more vertebrae.
A vertebra may be:
- Partially formed
- Wedge-shaped
- Joined to a nearby vertebra
- Divided abnormally
The curve may remain stable or worsen as the child grows.
Congenital scoliosis may occur by itself or together with abnormalities involving the spinal cord, ribs, kidneys, heart, or other organs
Dermal Sinus Tract
A dermal sinus tract is an abnormal channel that extends from the skin toward the spinal canal.
It may create a pathway for infection and can be associated with a cyst or tethered spinal cord.
Because of the risk of meningitis or spinal infection, some dermal sinus tracts require surgical treatment.
Diastematomyelia
Diastematomyelia, also called split cord malformation, occurs when the spinal cord is divided into two parts.
A band of bone, cartilage, or fibrous tissue may separate the two sections.
This condition may be associated with:
- Tethered cord
- Scoliosis
- Leg weakness
- Sensory changes
- Foot deformity
- Back pain
Hemivertebra
A hemivertebra is a vertebra that develops only partially, creating a wedge-shaped bone.
Because one side of the vertebra is shorter than the other, the spine may curve as the patient grows.
A hemivertebra may contribute to scoliosis, kyphosis, or both.
Klippel-Feil Syndrome
Klippel-Feil syndrome occurs when two or more cervical vertebrae are fused from birth.
Some patients have no symptoms. Others may develop:
- Limited neck motion
- Neck pain
- Headaches
- Spinal instability
- Scoliosis
- Nerve compression
- Spinal cord compression
Additional congenital abnormalities may also be present.
Lipomyelomeningocele
A lipomyelomeningocele is a congenital fatty mass attached to the spinal cord.
It may pull on the cord and cause tethered cord syndrome.
Symptoms may include weakness, numbness, orthopedic deformity, or bowel and bladder dysfunction.
Myelomeningocele
Myelomeningocele is a more severe form of spina bifida in which the spinal cord and nerves protrude through an opening in the spine.
It is usually identified before or shortly after birth.
The condition may cause:
- Leg weakness or paralysis
- Loss of sensation
- Bowel and bladder dysfunction
- Orthopedic deformity
- Hydrocephalus
- Difficulty walking
Patients often require lifelong care from several specialists.
Neurenteric Cyst
A neurenteric cyst is a rare congenital cyst that may develop near the spinal cord.
As it enlarges, it may compress the spinal cord or nerves.
Symptoms depend on the location and may include pain, weakness, numbness, or walking difficulty.
Sacral Agenesis
Sacral agenesis occurs when part or all of the sacrum fails to develop normally.
The condition may affect:
- Spinal alignment
- Pelvic stability
- Leg strength
- Bowel and bladder control
- Hip and lower-extremity development
The severity ranges from mild abnormalities to major neurologic and orthopedic disability.
Spina Bifida Occulta
Spina bifida occulta is a mild form of incomplete closure of the bones at the back of the spine.
It is relatively common and often causes no symptoms.
Some patients may have skin findings over the lower back, such as:
- A small dimple
- A patch of hair
- Skin discoloration
- A fatty lump
When associated with tethering or another spinal cord abnormality, further evaluation may be needed.
Tethered Cord Syndrome
Tethered cord syndrome occurs when the lower spinal cord becomes attached to nearby tissues and cannot move freely within the spinal canal.
As the body grows, the spinal cord may become stretched.
Symptoms may include:
- Back pain
- Leg pain
- Weakness
- Numbness
- Foot deformity
- Changes in walking
- Scoliosis
- Bowel or bladder dysfunction
Some patients are diagnosed in childhood, while others do not develop symptoms until adulthood.