5 Major Spina Bifida Neurosurgical Issues

Spina Bifida Educational Resourcehttp://www.spinabifida.net

What does “Spina Bifida” mean?

• Multiple related disorders

• Name refers to appearance on plain Xray: bifid (=split) spine

• All involve failure of the neural tube to disconnect from the skin, form a tube, and close correctly

What does “Spina Bifida” mean?

• Some skin-covered and some not

• If not skin-covered, associated with brain malformation (Chiari II)

Closure of Neural Tube

1. Sheet of ectoderm2. Neural “groove” forms down center3. Edges come together as a tube4. Future spinal cord breaks away from skin

Types of Spina Bifida

• Spina bifida aperta aka”open”

• Myelomeningocele (MM)

• Most common permanently disabling birth defect in US

• Most common non-lethal CNS birth defect

• Cord non-functional at and below lesion

• Focus of today’s talk

Spina Bifida Aperta

• Decreased incidence last 50 years

• Incidence 3.2/10,000 births

• Likely due to many factors:

• Maternal nutrition

• Folate

• Prenatal diagnosis/selective termination

Spina Bifida Aperta Myelomeningocele

Small Neural Placode

Large Myelomeningocele Sac

Intra-op View

Don’t forget the basics!

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