Prenatal diagnosis of open and closed spina bifida
T. GhiG. PiluPietro FalcoM. SegataA. CarlettiG CocchiDonatella SantiniMaria Paola BonasoniG. TaniN. Rizzo
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Abstract:
To identify criteria useful for differentiating closed from open spina bifida antenatally.A retrospective study of cases of spina bifida diagnosed in a referral center between 1997 and 2004.Of 66 cases of fetal spina bifida diagnosed at a median gestational age of 21 (range, 16-34) weeks, detailed follow-up was available for 57. Of these, open defects were found in 53 (93.0%) and closed defects in four (7.0%). Closed spina bifida was associated in two cases with a posterior cystic mass with thick walls and a complex appearance, while in two cases the spinal lesion could not be clearly differentiated from an open defect, particularly at mid-gestation. Open spina bifida was always associated with typical alterations of cranial anatomy, including the so-called 'banana' and 'lemon' signs, while in closed spina bifida the cranium was unremarkable. When the data were available, levels of amniotic fluid alpha-fetoprotein were always abnormally elevated with open spina bifida and within normal limits with closed forms.In this study 7% of cases of spina bifida diagnosed in utero were closed. The differentiation between open and closed forms is best shown by the sonographic demonstration of abnormal or normal cranial anatomy.Keywords:
Spina bifida occulta
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It is said that the causative factor of spina bifida is due to the disturbance of growth of the neural tube. Spina bifida is classified to two types, one is spina bifida occulta which is due to abscence of laminae and pedicles without sac-formation, the other is spina bifida cystica which is reserved for conditions in which a sac of dura mater and arachnoid protrudes through a cleft in the vertebrae. Now we experienced two cases of spina bifida occulta associated with epidermal cyst which is relatively rare as the tumor of the spinal region.Case 1. Male aged 4 years. Chief complaints are tumor formation at the lumbosacral region and deformity of bilateral feet. At the age of 3 years, the patient visited our clinic and was diagnosed spina bifida cystica with congenital club foot. After treatment of congenital club foot, plastic operation of spina bifida was performed. Fatty tumorous mass coming from subdural region was found and sac containing liquor or nerve root was not proved.The conditions after operation were not improved.Case 2. Female aged 30 years. Chief complaints are movement disturbance of right leg with hypaesthesia or anaesthesia of bitlateral lower legs.Disturbance of urinary bladder and rectum is not recognized. X-ray photo showed the defect of laminae at sacrum.At plastic operation, tumorous mass was found at the lumbar region and was resected but nothing resembling meningocele or sac containing liquor or nerve root were found.The conditions afer operation are improved especially in gait and sensory disturbance in left lower leg.
Spina bifida occulta
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Background/Purpose: This retrospective study was aimed to systematically analyze the radiological abnormalities of the brain and spine in children and adolescents with spina bifida (SB) and their association with cognitive function. Based on this systematic analysis, corresponding differences between spina bifida aperta (SBA) and spina bifida occulta (SBO) were identified.
Spina bifida occulta
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Abstract In recent years, researchers and clinicians have been interested in identifying factors associated with psychosocial adjustment among children and adolescents with spina bifida. Spina bifida is a heterogeneous condition characterized by an incomplete development of the spinal column. Subtypes of spina bifida include spina bifida occulta, identified by an abnormal spinal opening without spinal cord or nerve damage, and spina bifida cystica, characterized by the presence of a protruding fluid-filled sac that encloses the meninges (meningocele) or the meninges and spinal column (myelomeningocele). Finally, lipomeningocele is a subtype of spina bifida characterized by the presence of a fatty mass that herniates through the spinal column and attaches to the spinal cord, tethering the cord and often the associated nerve roots (Fletcher et al., 2004).
Spina bifida occulta
Meninges
Spinal column
Vertebral column
Posterior column
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Spina bifida occulta
Bowel management
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в работе представлен анализ особенности функциональных показателей следж-хоккеистов 11 лет с детским церебральным параличом и Spina Bifida. В результате исследования нами установлено, что среди рассматриваемых детей данного возраста с ДЦП (спастическая диплегия) и Spina Bifida occulta, занимающихся следж-хоккеем, были выявлены некоторые различия. Дети со Spina Bifida превалировали над детьми с ДЦП по большинству морфофункциональных показателей, а именно по массе тела, окружности грудной клетки, и по показателю динамометрии. Данные ЖЕЛ оказались одинаковыми в рассматриваемых группах.
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Spina bifida occulta
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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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Patient Education| 2021 Managing Chronic Health Needs in Child Care and Schools—Spina Bifida Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Share Icon Share Facebook Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Managing Chronic Health Needs in Child Care and Schools—Spina Bifida. Pediatric Patient Education 2021; 10.1542/ppe_document034 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All AAP SitesAll PublicationsPediatric Patient Education Search Advanced Search Subjects: Managing Chronic Health Needs in Child Care Spina bifida means cleft spine, which is an incomplete closure in the spinal column. A closed defect is characterized by spinal tissue that is covered by skin. An open defect is characterized by spinal tissue that is not covered by skin. The 4 types of spina bifida are Spina bifida occulta: One or more of the vertebrae (bones) of the spinal column has an opening without damage to the spinal cord.Occult spinal dysraphism (OSD): The child has a minor abnormality of the skin overlying the lower spine, such as a hairy patch, a pigmented area, or a small opening (sinus). The spinal cord below this abnormality is at high risk for injury as the child grows.MeningoceleMeninges, the protective covering around the spinal cord, have pushed out through the opening in the vertebrae in a sac called the meningocele.... © 2019 American Academy of Pediatrics. All rights reserved. You do not currently have access to this content.
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Spina bifida occulta
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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.
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