Myelomeningocele is a birth defect in which the backbone and spinal canal do not close before birth. The condition is a type of spina bifida.
Myelomeningocele is the most common type of spina bifida. It is a neural tube defect in which the bones of the spine do not completely form, resulting in an incomplete spinal canal. This causes the spinal cord and meninges (the tissues covering the spinal cord) to stick out of the child’s back.
The cause of Myelomeningocele is unknown. However, low levels of folic acid in a woman’s body before and during early pregnancy is thought to play a part in this type of birth defect. The vitamin folic acid (or folate) is important for brain and spinal cord development.
Exams and Tests
Prenatal screening can helps diagnose this condition. During the second trimester, pregnant women can have a blood test called the quadruple screen. This test screens for Myelomeningocele, Down syndrome, and other congenital diseases in the baby. Most women carrying a baby with spina bifida will have a higher-than-normal levels of a protein called maternal alpha fetoprotein (AFP).
Myelomeningocele can be seen after the child is born. A neurologic examination may show that the child has loss of nerve-related functions below the defect. For example, watching how the infant responds to pinpricks at various locations may reveal where he or she can feel the sensations.
Tests done on the baby after birth may include x-rays, ultrasound, CT, or MRI of the spinal area.
After birth, surgery to repair the defect is usually recommended at an early age. Before surgery, the infant must be handled carefully to reduce damage to the exposed spinal cord. This may include special care and positioning, protective devices, and changes in the methods of handling, feeding, and bathing.
Children who also have hydrocephalus may need a ventricular peritoneal shunt placed. This will help drain the extra fluid.