Purpose or Case Report: Neural tube defects affect approximately 1/1000 pregnancies; left untreated these defects may lead to devastating consequences. The purpose of this presentation is to: 1) familiarize the reader with the normal anatomy seen on neonatal spine ultrasound, 2) describe normal variants often encountered on spine ultrasound, 3) provide an illustrated summary of spine embryology, and 4) discuss the various pathologies/disorders that may occur during each phase of spine embryology.
Methods & Materials: Basic embryological development of the spine will be summarized using illustrations. Congenital spine abnormalities detailed in this educational presentation are depicted using a multimodality approach including prenatal and postnatal ultrasound and MRI.
Results: An overview of spine ultrasound and MRI anatomy will be provided with a description of normal variants. This will be followed by a pictorial review of the various pathologies broken down by the timing of the main embryologic insult. The various associated and non-associated cutaneous stigmata that may be seen overlying the spine in clinical practice will be discussed.

Specific disorders/pathologies that will be discussed include the following:
● Gastrulation: diastematomyelia, neuroenteric cyst
● Primary Neurulation: Neural Tube Closure (myelomeningocele, myelocele), Dysjunction (dermal sinus tract, lipomyelomingocele, lipomyelocele, intradural lipoma)
● Secondary Neurulation: fibrolipoma with tethered cord, terminal myelocystocele, caudal regression, sacrococcygeal teratoma.
Conclusions: Understanding the basic embryology of the spine can help predict the various abnormalities that may result. It is important for the pediatric radiologist to understand normal spine ultrasound anatomy and be familiar with normal variants that should not be confused with pathology. Recognizing the imaging appearance of the various congenital spine disorders is essential to aid in accurate diagnosis to lead to appropriate management.