Meningomyelocele

Sondra M. De Antonio, MD and John F. Bertagnolli, Jr., DO Reviewed 06/2019

BASICS

DESCRIPTION

Protrusion of nerve tissue and its covering through a defect in the vertebrae
Caused by incomplete neural tube closure during 3 to 4 weeks’ gestation, thus exposing meninges and spina...

DIAGNOSIS

HISTORY

Usually occur as isolated incidents

PHYSICAL EXAM

Examination of an infant’s lower back reveals obvious meningomyelocele involving lumbosacral spine.
Typically flaccid paraparesis below...

TREATMENT

GENERAL MEASURES

Pediatric specialists in neurosurgery, orthopedics, physiatry, urology, nursing, psychology, and social services are all necessary for a comprehensive integrated program of c...

ONGOING CARE

Periodic follow-up, usually every 6 months to assess

Head circumference (infants)
Ocular status
Developmental status
Motor status, including grasp strength in cooperative patients
Urologic an...

REFERENCES

Jiang J, Zhang Y, Wei L, et al. Association between MTHFD1 G1958A polymorphism and neural tube defects susceptibility: a meta-analysis. PLoS One. 2014;9(6):e101169. [View Abstract on...

ADDITIONAL READING

Ganesh D, Sagayaraj BM, Barua RK, et al. Arnold Chiari malformation with spina bifida: a lost opportunity of folic acid supplementation. J Clin Diagn Res. 2014;8(12):OD01–OD03...

CODES

ICD10

Q05.9 Spina bifida, unspecified
Q05.4 Unspecified spina bifida with hydrocephalus
Q07.03 Arnold-Chiari syndrome with spina bifida and hydrocephalus
Q05.6 Thoracic spina bifida without hydrocep...

CLINICAL PEARLS

Maternal folic acid and vitamin B₁₂ supplementation prior to conception and through 1st trimester reduces risk significantly.
Referral to a comprehensive integrated team of specialists ...

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