Myelomeningocele

What is it?

A myelomeningocele is a defect of the spine, spinal cord and spinal canal, in which the bones of the spine do not form the normal way, and the spinal cord and nerves are contained in a fluid-filled sac that sticks out the child’s back. A myelomeningocele can happen anywhere along the spinal cord, but it is most common in the lower back. Nerves below the level of the myelomeningocele usually are damaged.

Symptoms

A myelomeningocele higher in the spine results in more severe symptoms. The child may have:

  • Problems moving parts of the body below the opening in the back
  • Lack of sensation in their legs and feet
  • Poor or no bowel and bladder control
  • Twisted or abnormal legs and feet, such as, clubfoot

Diagnosis

Often, the condition is detected during regular pregnancy screenings. If not, it is diagnosed right after a baby is born, when the sac holding the spinal cord is seen pushing through the baby’s back. Doctors may order certain tests to assess their spine and plan treatment, such as blood work, physical exam, ultrasound, and MRI.

Treatment

Surgery to repair the defect in a baby’s spinal column is just the first step in the treatment. Each child is different, and it is necessary to tailor the treatment for each child individually.

Within a baby’s first 2 days of life, surgery is performed to cover and protect the baby’s spinal cord. This limits the risk of infection, and prevents more damage to the spinal cord but does not restore damaged nerves.

During surgery the spinal surgeon closes the covering around the spinal cord, then closes the muscles and fascia over the spinal cord, and finally the skin over the open area is closed.