What Are the Different Types of Sacral Dimples?

Sacral dimples can be “typical” or “atypical”.

Typical dimples are found at the skin on the lower back near the buttocks crease. No other skin changes are seen.

Atypical dimples may be located higher up on the back or off to the side. The bottom of the dimple may not be visible, and sometimes the dimple is accompanied by changes in skin color, a collection of hair, a lump or a skin tag.

What Complications Can Be Seen With a Sacral Dimple?

Rarely, sacral dimples are associated with a problem with the spine or spinal cord. This risk is higher if the dimple has atypical features.

Examples include:

  • Tethered spinal cord - Normally the spinal cord hangs freely within the spinal canal. In tethered cord, there is tissue attached to the spinal cord that limits its movement.
  • Dermal sinus tract - This is an abnormal connection between the skin and spine that can lead to infection.
  • Spina bifida occulta - A mild form of spina bifida can occur when the spine doesn’t close correctly around the spinal cord but the cord remains in the spinal canal. This usually causes no symptoms.

How is a Sacral Dimple Evaluated?

  • If your child has a typical dimple, is otherwise healthy and there is no family history of spinal cord problems, usually no testing or specialty referral is necessary.
  • If your child has an atypical dimple, your doctor will likely recommend imaging with an ultrasound or MRI. Sometimes your doctor will have your child see a spine specialist, called a neurosurgeon, to help determine when to perform imaging and which type is best for your child.
  • If an underlying abnormality is found, the doctor will discuss with you whether any treatment is needed.

When Should I Call My Doctor?

If your child has an atypical dimple, it is important to seek medical attention for any fever >100.4. Be sure to tell the doctor about your child’s sacral dimple.

Rev. 3/2013. MassGeneral Hospital for Children and Massachusetts General Hospital do not endorse any of the brands listed on this handout. This handout is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treatment of any medical conditions.