Myelomeningocele – a severe malformation of the spine, where for some reason it remains nonunion, false opening, through which comes out a hernia. It is filled with not only the CSF, but the spinal tissues and nerve roots.
The disease is considered to be one of the most difficult, as it often ends in complete paralysis of the entire body and it is fatal shortly after birth. The incidence is 1-2 cases per thousand babies born alive. Most often pathology is found in children who have been diagnosed with “hydrocephalus or Chiari malformation of the second type”.
The exact cause of this disease is not known. Neural tube defects can be hereditary or develop under the influence of some adverse factors. For example, this condition can develop again if one of the children in the family already had a similar anomaly.
It is believed that defects in development of neural tube huge value is created by the lack of folic acid. That is why doctors advise to start taking this vitamin in the period of planning pregnancy and continue throughout the first trimester, all of the time, while they actively formed the internal organs of the fetus.
Also, the reason may be receiving mother some anticonvulsants and diabetes. This means that all medications that pregnant does during gestation should be appointed only by a physician.
The symptoms will depend on the severity of the disease, and where in the back has a hernia. Most often it is the back, so the main symptom is total paralysis of the legs due to impaired functioning of the nervous roots.
In addition to movement disorders developing impaired skin sensitivity, and almost completely cease to function of the pelvic organs – the bladder and bowels. Because of this, there is a risk of development of inflammatory process.
Depending on what other symptoms are present, the patient can be pronounced the following symptoms:
- The asymmetry of the face.
- Impaired swallowing.
Most often, the shell that appeared in the hernial SAC, covered by skin. But sometimes not, and then on the back is an open wound. Therefore, to help such a child should be almost in the first hours after birth. If this is not done, then there is a high probability of infection that will eventually lead to death from sepsis.
Pathology is diagnosed during the intrauterine development of the fetus, so parents have time to choose between abortion and childbirth. Sometimes surgery the baby is held immediately after birth, especially if the hernia has skin and the whole wound open.
For the diagnosis of foetal ultrasound and in other cases can be treated with MRI.
Myelomeningocele without communication with the spinal canal does not exist. There is always an involvement of not only the spinal membranes, but also of the spinal cord and nerve roots.
Treatment only surgery that should be performed during the first few hours or days of life, therefore such children a woman should give birth in a specialized hospital.
During the operation, all the fabrics are placed inside the spine, and the hole is sutured. You may need to install a shunt, which would have diverted excess fluid from the brain into the abdominal cavity. This is typical for children, which was glorified with the diagnosis of “hydrocephalus”.
But even surgery can not cure paralysis of the legs, and to restore the function of the bladder and intestines. So many children for life remain disabled.
After surgical treatment it is assumed physiotherapy, massage and therapeutic exercise. Also parents should decide the issue of violation of urination and problems with defecation. Most often, the child life wears diapers. Also required to carry out prevention of inflammatory diseases of the bladder.
The forecast can be considered to be conditionally adverse. Although after the hernia repair is not observed, but neurological and physical impairments not disappear. Have many after birth ceases to grow spinal cord that can’t be fixed in any way.
The majority of children has hydrocephalus, and with the simultaneous combination of this disease with myelomeningocele child will have different phase retardation and learning it is not possible.