MR imaging is the procedure of choice that provides the most detailed picture of the spinal malformation and of the associated intracranial abnormalities. Recent advances in sonography have allowed its image quality to improve significantly enough that its diagnostic value is equal to that of MRI. Sonography can now characterize nearly all spinal anomalies sufficiently in the first days of life. This allows the clinical determination of whether the lesion requires urgent intervention or whether further radiologic evaluation with studies such as MRI can be delayed until therapeutic intervention is more imminent. Plain X-ray reveal the degree of spina bifida with overt meningocele or meningomyelocele, the pedicles and lamina are splayed in addition to the failure of fusion. If the vertebral bodies are split, bony malformations are well shown by CT and diastematomyelia, aberrant lamina and spina bifida are best assessed by using it. However, MRI will generally allow adequate analysis of the spinal deformities.