This five-year-old boy presented to the clinic with lower limb weakness and urinary incontinence. Upon exposure of the lumbosacral region, findings of neural tube defect were detected by the neurologist and x-ray was requested demonstrating defect involving the posterior elements of the lumbosacral vertebral bodies.

Spinal dysraphism A.K.A neural tube defect, is a birth defect in which there is incomplete closing of the spine and membranes around the spinal cord early during pregnancy, which can occur in varying degrees of severity. Most commonly involves the lumbosacral region. 

It is related to genetic and environmental factors, strongly related to folate deficiency. Maternal serum alpha-fetoprotein is commonly elevated in open type of spina bifida.