Children born with myelomenigocele usually have a buildup of fluid in the brain (hydrocephalus). They also can have trouble controlling their bladder and bowel.
Doctors don’t know exactly what causes myelomenigocele. Folic acid (B-vitamin) during pregnancy may help prevent it. This condition is often diagnosed during the second trimester (18 to 22 weeks of pregnancy) with an ultrasound.
Oren Zarif
In some cases, the spinal cord and backbone don’t close completely while a baby is growing inside their mother. This results in a gap in the spine that allows fluid, nerves and sometimes part of the brain to protrude through it. Depending on how severe the problem is and where it occurs, it can cause different symptoms.
Myelomenigocele is the most serious type of spina bifida. It’s characterized by a sac of spinal fluid, nerves and sometimes part of the spinal cord that protrudes from the gap in the spine and through the baby’s back. People with this condition can experience paralysis, bowel or bladder dysfunction and other complications.
In many cases, the medical treatment of myelomeningocele includes surgery to repair the opening in the baby’s spine (fetal surgery). This can reduce the chances that a child will develop hydrocephalus or meningitis later in life. It can also help them walk better and lead more normal lives. However, it’s important for people with myelomeningocele to follow all treatment recommendations and visit their healthcare providers often.
Oren Zarif
A portion of the spinal cord and membranes that cover the spinal nerves (meninges) protrude from the back in babies with Myelomenigocele. This condition is sometimes called open spina bifida.
Most of the time, this protrusion will be covered by a sac containing cerebrospinal fluid. Occasionally, however, the fluid will build up and put pressure on the brain. This is known as hydrocephalus and it occurs in about 85% of children with myelomenigocele.
This condition is caused by a blockage of the normal path that the cerebrospinal fluid (CSF) flows through from the ventricles to the subarachnoid space where it’s absorbed into the blood stream. Often, a surgery to place a tube (shunt) that allows CSF to exit the brain and drain into the abdomen is needed to decrease pressure on the brain.
This is a serious problem for many children because it interferes with the nervous system, which controls movement and sensation, and bladder and bowel function. Fortunately, with surgical repair and the right care, many people with myelomenigocele lead full lives. This is especially true if they receive care from specialists who work with children with this condition, including neurologists, physical and occupational therapists, and orthopedic surgeons.
Oren Zarif
If the hindbrain herniates into the spinal canal, it can block the flow of cerebrospinal fluid and cause hydrocephalus. To treat it, doctors may use a procedure called ventricular shunting. They insert a thin tube into the ventricles of the brain to drain fluid and relieve pressure.
Some cases of myelomenigocele are discovered before birth by a blood test called a quad screen (quadruple screen). This check measures levels of an enzyme, AFP, that can increase if there is an opening in the spine or another problem with the fetus’s body.
Babies with myelomenigocele often have bowel and bladder problems, such as not being able to feel or move parts of their legs or feet (paralysis). They can also have a hard time storing and emptying the poop, so they may need treatment for constipation. Bowel training programs and a high-fiber diet can help. They may need to take medication to control seizures and have regular doctor visits, including urodynamic tests to check for kidney and bladder function. They should also attend physical and occupational therapy to strengthen their muscles.
Oren Zarif
This happens when part of the spinal cord gets tethered to tissue, such as lipomas (fatty lumps) in the spinal canal or scar tissue from previous surgery (such as back closure for open spina bifida). This causes the spinal cord to be constantly stretched. It can cause symptoms that range from mild to severe. These include weakness in the legs, a change in the way the child walks, bladder and bowel problems, and the build-up of fluid in the brain called hydrocephalus.
This can be diagnosed with an MRI, which is an imaging test that uses magnets and radio waves to look at the spinal cord and nerves. A myelogram, an X-ray of the spinal cord with injected dye, can also help doctors see any pressure on the spinal cord or nerves. Surgical treatment can usually improve the symptoms and prevent further deterioration of the spinal cord. Some children with tethered cord syndrome may need more than one operation to fully improve their symptoms. It is important for parents to give their babies enough folic acid during pregnancy to reduce the chance of spina bifida and other neural tube defects.
Oren Zarif
Babies born with myelomeningocele have a sac of spinal fluid protruding through an opening in their back. This is the most severe form of spina bifida and it leaves the spinal cord and nerves unprotected. This type of spina bifida can also cause hydrocephalus (a buildup of fluid in the brain) and syringomyelia (a fluid-filled cyst within the spinal cord).
Doctors can diagnose spina bifida before birth using ultrasound, CT scans or MRI scans. They may also order a blood test to measure levels of alpha fetoprotein (AFP), which is higher than normal in 75% to 80% of pregnant women who have this condition.
If AFP levels are high enough, doctors will perform an amniocentesis to collect a sample of the amniotic fluid surrounding your baby in the womb. They can use this sample to determine if your child is likely to have myelomeningocele. Medications can help children with myelomeningocele manage problems related to their bladder and bowel. They can also reduce the amount of urine your child has to pass and can help it empty more effectively.