Spina bifida is a common birth defect affecting the central nervous system and represents
a group of neural tube defects caused by congenital dysraphic malformations of the
vertebral column and/or spinal cord. The anatomy in these patients is challenging and
includes structural and vascular abnormalities including arteriovenous malformation or
fistulae, and fatty substitution of paravertebral tissues. A magnetic resonance image
(MRI) is needed for management of patients with lumbar radiculopathy and clinical
features suspicious of occult spinal dysraphism. Risks and benefits of lumbar epidural
steroids should be discussed comprehensively with those patients and in the best case
scenario be avoided. Occult spinal dysraphism poses a clinical dilemma for interventional
pain specialists managing those patients with lumbar radiculopathy. We report a case
of occult spinal dysraphism discovered following the development of post-traumatic
radicular symptoms.
Key words: Occult spinal dysraphism, spina bifida, lumbar radiculopathy, pain, pain
management, physical findings