The problem with this is that, as I stated above, at least two percent of babies may have these pits. That's one in every 50 babies. And almost all of these pits are insignificant when it comes to serious problems or involvement of deeper tissues. Therefore, what do doctors look for to decide who ought to have additional tests to examine the deeper tissues? There are a number of things, but some of them include:
-- Can the floor of the pit or dimple be easily visualized? Divots in which the bottom portion cannot be seen may be evidence of a neural tube that never closed completely.
-- Does the pit have a tuft of hair growing from it? This again make a pit suspicious for deeper involvement.
-- Is the neurologic exam normal? If there is significant involvement of the spinal column, there may be weakness in the legs.
-- How high up on the back is the dimple? Most dimples very low on the back (just above the buttocks) are of little concern. The higher the dimple is, the more likely it is to be associated with defects in deeper tissues.
-- Are there signs of any other defects? The brain, spinal column, kidneys, as well as other structures form at the same time the neural tube closes. Therefore, if there are any malformations in any other parts of the body, it becomes more concerning that the neural tube may be involved as well.