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 |  | Well-Baby Exams: About $668 |  | Lumbar Spinal MRI: About $2,000 |  | Tethered Spinal Cord Surgery: $20,000+ |
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A sacral dimple is an indentation on the lower back that is present at birth. It is not a serious disorder in itself and often requires no treatment. However, it can be a sign of one or more serious conditions, such as a tethered spinal cord or a thickening at the end of the spinal cord, that fall under the category of spina bifida occulta -- or "hidden" spina bifida.
Typical costs: | - For patients not covered by health insurance, sacral dimple treatment typically costs no more than the routine well-baby exams recommended for any infant because, in most cases, no special treatment is required. Well-baby exams cost about $668 for the seven recommended exams in the first year of life. The doctor can monitor the sacral dimple at these visits.
- In cases where an underlying problem is suspected, an MRI typically will be required to determine whether there is an underlying spinal problem. The average cost of a lumbar spinal MRI is about $2,000, according to NewChoiceHealth.com[1] .
- If an underlying problem is discovered, typically a tethered spinal cord or one of the other disorders that fall under the category of spina bifida occulta[2] , the child might need surgery. Surgery for a tethered spinal cord typically costs about $20,000 or more, according to one study. Costs could rise considerably if the child requires multiple surgeries or if there are other complications.
- Treatment of an underlying disorder associated with a sacral dimple typically would be covered by health insurance. Costs for a patient with health insurance would typically include an office visit copay, an MRI copay, coinsurance of 10% to 50% for the surgery and copays for any pain medication or other prescription drugs. This could reach the out-of-pocket maximum.
Related articles: Well Baby Doctor Visit, MRI
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What should be included: | - The pediatrician will examine the sacral dimple for signs that might indicate an underlying problem -- such as size, depth, how far it is from the base of the buttocks and whether there is a concurrent skin issue such as a hemangioma birthmark or a tuft of hair near the dimple. In general, a larger, deeper dimple that is further up the back or has a concurrent skin issue might be more concerning. With dimples that do not meet any of those criteria, there is rarely an underlying problem; with dimples that do meet one or more of the criteria, there was an underlying problem 40% of the time, according to one study cited by pediatrician Alan Greene. Unless there is an underlying problem, no treatment is needed.
- The Mayo Clinic[3] offers information about sacral dimples. Akron Children's Hospital in Ohio offers an overview of diagnosis and treatment. The Spina Bifida Association[4] offers an overview of hidden spinal conditions.
- If an underlying spinal problem is discovered, surgery might be required. The type of surgery depends on the type of problem. Surgery for a tethered spinal cord typically requires general anesthesia and takes four to six hours; after the surgery, the patient must lie flat for a day or two. In infants, aftercare typically requires cutting the back of the diaper down and applying special drapes or dressings to keep the wound clean. The National Institute of Neurological Disorders and Stroke[5] offers a primer on tethered spinal cord diagnosis and treatment.
Additional costs: | - If the sacral dimple is a sign of an underlying problem, such as a tethered spinal cord, which is treated with surgery, pain medication probably will be prescribed. The child will also require regular follow-up visits and MRIs.
Discounts: | - InsureKidsNow.gov[6] offers help getting health insurance for children.
Shopping for sacral dimple treatment: | - A board-certified pediatrician should evaluate a sacral dimple to determine whether testing, such as an MRI, is needed. The American Academy of Pediatrics has a doctor finder by zip code; board certification can be verified by the American Board of Pediatrics[7] . And KidsHealth.org[8] has a guide to finding a pediatrician for a new baby. If surgery is required, a pediatrician can provide a referral to a pediatric neurosurgeon[9] .
- If an underlying condition, such as a tethered spinal cord, is detected, and surgery is recommended, it is important to discuss risks with the surgeon. Risks of spinal surgery on infants include reaction to anesthesia, infection, bleeding, blood clots, pain, and damage to the spinal cord that can cause loss of function, including bladder and bowel function.
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Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
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External Resources: | - www.newchoicehealth.com/Directory/Procedure/43/Lumbar%20Spine%20MRI
- www.spinabifidaassociation.org/site/c.evKRI7OXIoJ8H/b.8028963/k.BE67/Home.htm
- www.mayoclinic.com/health/sacral-dimple/DS00753
- www.spinabifidaassociation.org/site/c.evKRI7OXIoJ8H/b.8028963/k.BE67/Home.htm
- www.ninds.nih.gov/disorders/tethered_cord/tethered_cord.htm
- www.insurekidsnow.gov/
- /www.abp.org/MOCVerification/VerificationServlet
- kidshealth.org/parent/system/doctor/find_ped.html
- www.healthychildren.org/English/family-life/health-management/pediatric-specialists/pag...
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