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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

1
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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