Spinal dysraphism
- Spinal dysraphism is an umbrella term for conditions caused by abnormal closure of the neural plate
- The most important cause is maternal folic acid deficiency during pregnancy
- Types
- Closed spinal dysraphism (spina bifida occulta)
- Asymptomatic
- Due to incomplete closure of vertebrae
- Open spinal dysraphism (spina bifida cystica)
- Meningocele – herniation of meninges
- Myelomeningocele – herniation of meninges and spinal cord
- Closed spinal dysraphism (spina bifida occulta)
- Treatment
- Antibiotic prophylaxis from birth to surgery
- Surgical closure
- Within 72 hours of birth
- Postoperative monitoring for hydrocephalus
- If it develops, place a ventriculoperitoneal shunt
- Regular follow-ups throughout life
- Prognosis
- Nearly all patients with myelomeningocele develop neurogenic bladder and faecal incontinence
- Many develop orthopaedic problems like scoliosis, foot deformities, hip deformities, pathologic fractures due to osteopaenia, etc.