During development, at each level of the spine two plates of bone migrate towards one another and fuse, in the midline, forming what are referred to as spinous processes. It is the tips of these spinous processes that we feel when running a finger down our spines. Sometimes one or more of the pairs of plates fail to fuse adequately, such that two, shorter spinous processes form on each side of the midline. This is what is referred to as spina bifida. It affects most commonly the lower part of the spine, in the lumbarThe small of the back, below the ribcage or, in neurological practice, the spine in this region. region. Many people may quite unaware that they have such split (or, more specifically, never joined), spinous processes. Plain radiographs, or magnetic resonance imagingA highly sophisticated form of obtaining images (pictures) of the internal structures of the body. Unlike some other forms of imaging, magnetic resonance imaging does not involve the subject being exposed to ionising radiation, which can be harmful if used to excess. Magnetic resonance imaging can reveal not just structures but information about how well or otherwise body parts are functioning., may reveal such an abnormality as an incidental finding. At the other end of the spectrum, severe and extensive spina bifida affects not only the bony elements but also neural elementsThe brain, the spinal cord and the nerves that connect these structures to all parts of the body can be referred to as neural elements, to distinguish them from other parts, in particular their protective coverings, such as the meninges and skeletal elements. of the spine, with the formation of meningocœles and myelomeningocœles. Less severe associated neural abnormalities include a low-lying cordSee tethered cord. and diastematomyeliaA nightmare word for medical secretaries to type, from dictation. It refers to a bony spur, or a fibrous band, that passes through the spinal cord, from front to back. It is a congenital abnormality. It is commonly associated with spina bifida and syringomyelia and can be a cause of a tethered cord..
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