Results of a study by Kriss and Desai3 showed that the incidence of cutaneous stigmas in a healthy neonate population was 4.8 percent. This study3 also evaluated 207 neonates with cutaneous stigmas and found that none of the infants with a simple midline dimple (meeting none of the three criteria listed above) had spinal dysraphism. Eight of the 20 (40 percent) atypical dimples (one of the criteria was met) were positive for sacral dysraphism.3

The data in this prospective study reveal that simple midline dimples are the most common dorsal cutaneous stigmata in neonates and pose an extremely low risk for sacral dysraphism. When none of the criteria are met, the negative predictive value for a simple dimple in this study was 100 percent. The cost of screening these dimples or clefts with MRI and neurosurgical consultation would be excessive and unnecessary.


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Background:  Although spinal cord tethering is known to be associated with certain clinical syndromes and cutaneous stigmata, its incidence in healthy infants with simple sacral dimples has not been thoroughly evaluated.

Materials and methods:  We reviewed the lumbar spine US reports of all healthy neonates referred for a simple sacral dimple during a 12-year period at two children's hospitals. A sonogram was considered abnormal for a conus medullaris terminating below the L2-L3 disc space, decreased conus or nerve root motion, an abnormal filum terminale, or for the presence of an intraspinal mass, osseous dysraphism, or a sinus leading to the thecal sac. The medical records of patients with abnormal screening sonograms were reviewed to determine the final clinical outcome.

Subjects seeking aesthetic surgery for facial dimples are increasing in number. Literature on dimple creation surgery are sparse. Various techniques have been used with their own merits and disadvantages. ff782bc1db

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