A one-week-old, late preterm baby was brought with a cystic swelling over the lumbar spine since birth. There was a skin tag covering the swelling..
The MRI examination of the whole spine, T2 and T1 sagittal sections reveal a well defined, T2 hyperintense, CSF-intensity, sac-like protrusion in the midline, dorsal to the lumbosacral spine. This lesion communicates with the spinal canal through a posterior vertebral arch defect at the L4-L5 level. The distal spinal cord and filum terminale herniate into the sac. There is T1 bright fat signal in the canal that communicates with the prominent subcutaneous fat via this defect. The neural placode-lipoma interface is located outside the spinal canal.