Occult intrasacral meningocele associated with spina bifida: A case report
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Keywords:
Occult
Etiology
Tethered Cord
Spina bifida occulta
Encephalocele
Spina bifida and tethered spinal cord are congenital diseases that can lead to severe disability. At present, most doctors in relevant specialties in China still have insufficient understanding of spina bifida, resulting in high incidence and aggravation of its complications. To provide guidance for the diagnosis and treatment of spina bifida and tethered spinal cord in China, experts from neurosurgery, urology, orthopedics, spine surgery, and rehabilitation departments who have experiences in the diagnosis and treatment of spina bifida discussed and summarized their experiences, and referred to the relevant literature on the diagnosis and treatment of spina bifida at home and abroad. Expert consensus was formed in the following aspects: concept, classification, and pathological changes of spina bifida; diagnosis; treatment process and operation timing; principles and methods of treatment; rehabilitation; and follow up. This expert consensus can provide reference for relevant care providers of spina bifida in China.脊柱裂、脊髓拴系是一类可导致严重残疾的先天性疾病。目前我国相关专科的大部分医生对脊柱裂认识不足，导致并发症高发，疾病加重。为了给临床脊柱裂、脊髓拴系诊治提供指导意见，中国残疾人康复协会脊柱裂学组组织具有脊柱裂诊治经验的神经外科、泌尿外科、矫形外科、脊柱外科和康复科专家讨论、总结经验，并参阅国内外脊柱裂诊治相关文献，制定本专家共识。该共识主要包括脊柱裂概念、分型和病理改变，诊断，治疗流程和手术时机，治疗原则与方式，康复以及随访，从多个方面为我国脊柱裂相关专科医生提供参考。.
Spina bifida occulta
Spinal dysraphism
Tethered Cord
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Tethered Cord
Urodynamic studies
Spinal dysraphism
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Occult
Etiology
Tethered Cord
Spina bifida occulta
Encephalocele
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Spina bifida occulta
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Neural tube defects such as anencephaly, spina bifida, and encephalocele are congenital anomalies of the central nervous system. Data on the prevalence of neural tube defects in Kenya are limited. This study characterizes and estimates the prevalence of spina bifida and encephalocele reported in a referral hospital in Kenya from 2005-2010.Cases were defined as a diagnosis of spina bifida or encephalocele. Prevalence was calculated as the number of cases by year and province of residence divided by the total number of live-births per province.From a total of 6,041 surgical records; 1,184 (93%) had reported diagnosis of spina bifida and 88 (7%) of encephalocele. Estimated prevalence of spina bifida and encephalocele from 2005-2010 was 3.3 [95% Confidence Interval (CI): 3.1-3.5] cases per 10,000 live-births. The highest prevalence of cases were reported in 2007 with 4.4 (95% CI: 3.9-5.0) cases per 10,000 live-births. Rift Valley province had the highest prevalence of spina bifida and encephalocele at 6.9 (95% CI: 6.3-7.5) cases per 10,000 live-births from 2005-2010.Prevalence of spina bifida and encephalocele is likely underestimated, as only patients seeking care at the hospital were included. Variations in regional prevalence could be due to referral patterns and healthcare access. Implementation of a neural tube defects surveillance system would provide a more thorough assessment of the burden of neural tube defects in Kenya.
Encephalocele
Anencephaly
Neural tube defect
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Objective The aim of the research is to study the bowel dysfunction associated with spina bifida, analyze the cause and review the management. Methods Thirty three children(age range: 4 days to 10 years) admitted between January 1996 and October 1997 were reviewed. According to physical finding and MRI examination, they were categorized into spina bifida cystica( n =13), spina bifida occulta( n =7) and repair of meningomyelocele( n =13). All children suffered from either constipation or fecal incontinence. Some suffered from urinary incontinence, paraplegia and talepes. Results Twenty two children underwent tethered cord release. Using Kelly’s bowel function scoring system, we found that 5 patients( 23?% ) recovered completely, 10 patients( 45?% ) improved, 6 patients( 27?% ) experienced no improvement. One was lost in the follow-up.Conclusions Tethered cord syndrome is one of the factors leading to bowel dysfunction. Operative management results in improvement of neurological function. Children with spina bifida cystica should undergo MRI examination to exclude other anomalies preoperatively.
Fecal Incontinence
Bowel management
Spina bifida occulta
Tethered Cord
Paraplegia
Bowel function
Neurological examination
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Authors examined 80 pairs of parents with affected children with spina-bifida. They compared the incidence of spina-bifida occulta in parents and in 211 controls. The conclusion is: there is no increased incidence of spina-bifida occulta in parents of spina-bifida.
Spina bifida occulta
Occult
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Abstract In the period 1980–1987, neural tube defects were two to three times more prevalent in populations covered by EUROCAT registries in the United Kingdom and Ireland (UKI) than in Continental Europe and Malta (CEM). 1864 NTD cases in a total population of 580,000 births in UKI and 455 cases in a population of 380,000 births in CEM were analysed to find if there were differences in the ratio of prevalence rates between UKI and CEM according to site of the defect and association with non‐central nervous system (CNS) anomalies. The prevalence rate ratio was high for anencephaly with accompanying spina bifida, iniencephaly, and upper spina bifida, and low for encephalocele, lower spina bifida, and anencephaly without other neural tube defects. There was a greater female excess for anencephaly with accompanying spina bifida, iniencephaly, and upper spina bifida than for other defects in both geographic areas. There was a female excess for encephalocele in UKI but a male excess in CEM. Certain sites (anencephaly with accompanying spina bifida, iniencephaly, and encephalocele) were more likely to have accompanying non‐CNS anomalies. The prevalence rate ratio of multiply malformed NTD was in general lower than for isolated NTD but showed the same pattern by site. The prevalence rate ratio was high for multiply malformed anencephaly with accompanying spina bifida, iniencephaly, and upper spina bifida. The sex ratio was similar between isolated and multiply malformed cases when site of the defect is taken into account. It is concluded that the geographic prevalence pattern and sex ratio differ according to site of NTD but do not differ substantially according to whether NTD is isolated or associated with non‐CNS anomalies.
Anencephaly
Encephalocele
Spina bifida occulta
Neural tube defect
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A case-control study of neural tube defects (NTD) was undertaken from 1979 to 1986 in the department of Bas-Rhin in Northeastern France. For 105,374 consecutive births the incidence of spina bifida was 0.62 in 1,000, the incidence of anencephaly was 0.33 in 1,000 and that of encephalocele was 0.14 in 1,000. Sex ratios were respectively 1.06, 0.64 and 0.75. Among the numerous etiological factors which were studied we observed a seasonal factor (more conceptions in April, less in September). Birth weight and length were lower in children with spina bifida than in controls. Metrorrhagia was more frequent during pregnancies with anencephaly as was oligoamnios in pregnancies with encephalocele. Routine US prenatal diagnosis, which was performed in 90% of the pregnant women, allowed diagnoses in 88% of the fetuses with anencephaly but only in 53% of the fetuses with spina bifida and in 64% of the fetuses with encephalocele. For these last two anomalies diagnosis could often be performed because a malformation was associated with a NTD.
Anencephaly
Encephalocele
Etiology
Neural tube defect
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We present our personal experience on patients with Spina Bifida. It is the result of having treated 1600 children for 12 years at Shanghai Children's Medical Center. We classify the cases on Spina Bifida Manifesta (myelomeningocele, myelocele, lypomyelomeningocele) or Spina Bifida Oculta (lipoma, dermal sinus and thickened filum terminale). For the former, we recommend surgery within 24-48 h after birth. For the latter we recommend preventive surgery months after birth. We acknowledge that the diameter of the spinal canal is a problem for large remnant lesions. In cases of myelomeningocele, we prefer to place the shunt and close the defect in the same procedure, it reduces the risks inherent to exposure to anesthesia, reduces hospital stay, and related costs. If there is a suspicious of infection, we do not place the shunt on the same procedure. The personal description of the preferred techniques for closure of the different defects is described.
Filum terminale
Spina bifida occulta
Tethered Cord
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