If your baby is born with myelomeningocele, you want to ensure you find him or her the most advanced treatments available. Understanding this defect and what can be done to help repair it is the first step towards giving your child the best chance at a successful recovery.
Myelomeningocele is the most severe form of the condition known as spina bifida. This defect happens in utero. During development in the womb, your baby’s spine, along with the other spinal structures including the spinal cord and canal, do not fully form or close as they should.
Essentially, a small membrane-covered sac protrudes through an opening in the spine where full development didn’t take place. This sac contains cerebrospinal fluid, meningeal tissue (the layers of tissue that protect the spinal cord) and possibly a portion of the spinal cord along with nerves. With normal movement, either in utero or during the birthing process, this sac can open up, exposing the spinal cord and nerves to damage and infection.
In the majority of cases, myelomeningocele occurs in the lumbar or sacral region of the back (lower back). The symptoms tend to be less pronounced in babies with lower myelomeningoceles as opposed to those that have them develop further up their spines.
Symptoms of Myelomeningocele
The symptoms of myelomeningocele are varied and can range in severity depending on the location of the defect. Babies that are suffering a myelomeningocele can experience:
- A lack of sensation throughout their legs and feet
- Difficulty moving the parts of their body located below the opening in their back
- Abnormally-formed or twisted legs and feet, including problems such as clubfoot
- The development of a Chiari 2 malformation, which affects how the inferior portion of brain forms
- Bowel and bladder control issues
- Learning delays
- Hydrocephalus, which is the presence of an excess of cerebrospinal fluid in the head
Diagnosis of Myelomeningocele
Myelomeningocele can be diagnosed while your baby is still in utero. Using a test called a quadruple screen, which will allow for the detection of a certain protein called maternal alpha-fetoprotein (AFP), can indicate that your developing child could have spina bifida. Other testing procedures that can help identify myelomeningocele before your baby is born include ultrasound and amniocentesis. If your doctor suspects there may be problems, he or she will discuss this with you and you can create a plan for further testing.
In the case where your baby’s myelomeningocele is found after birth, imaging tests will allow your doctor to assess the severity and location and also note any other spinal abnormalities that are not obvious. The most widely used imaging techniques include ultrasound, x-rays, MRIs and CT scans.
Treatment Options for Myelomeningocele
The main treatment for myelomeningocele is a surgical correction. A team of neurosurgeons work to carefully realign the spinal cord and close the meninges. Then the muscles are brought back into place to cover the spine and the skin sutured over the opening. This is preferably performed within the first forty-eight to seventy-two hours of your baby’s life to not only prevent further damage to the spinal cord, but to also help avoid infection.
In some cases, when the defect is identified while you are still pregnant, surgical repair can be made in utero. Not all mothers and babies are good candidates for this surgery but those that are typically have successful outcomes.
Why Choose Neurosurgeons of New Jersey
You want the best for your baby and the doctors and staff at Neurosurgeons of New Jersey do, too. We understand the importance of giving your child the best possible start in life and strive to provide only the best, most advanced surgical options to help ensure this. Our team of highly experienced surgeons and staff will work with you, answering all of your questions and providing not only the medical but also the moral support you need while helping you and your baby through the treatment and healing process.