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Myelomeningocele is a birth defect where the neural tube doesn’t fully form, causing a collection of excess spinal fluid, nerve tissue, membranes, and bone at the base of the back. Emergency surgery is usually required, and lifelong medical care and physical therapy are often necessary. Causes are largely unknown, but obesity, diabetes, and drug use in pregnant women are risk factors. Children with myelomeningocele often have limited sensory perception and control over their bladder and bowels, and may face developmental problems. Supportive back braces and regular checkups are needed to monitor their cognitive and physical development.
Myelomeningocele is a severe form of spina bifida present at birth. It refers to a defect in the development of the neural tube, a precursor to the spinal cord. The spinal cord never fully forms, and a collection of excess spinal fluid, nerve tissue, membranes, and bone pools at the base of the back. A child born with myelomeningocele may experience paralysis of the legs, limited sensory capabilities, and lack of control over bladder and bowel function. Doctors usually decide to conduct emergency surgery to correct the deformity, and people with myelomeningocele often need to receive medical care and engage in lifelong physical therapy.
The neural tube stimulates spinal cord and brain development in healthy fetuses. The maturing spinal cord is normally enclosed within membranes called the meninges, which protect and cushion the long nerves. In the case of myelomeningocele, the base of the neural tube never closes completely. Meninges, nerves, and vertebrae in the lower back protrude outward into a fluid-filled sac covered with skin. If the skin breaks down, the deformity could appear as a large open lesion. The causes of myelomeningocele are largely unknown, although obesity, diabetes, and drug use in pregnant women are significant risk factors.
Because major nerves are affected, children with myelomeningocele usually lack sensory perception and control over their bladder and bowels. Some children are paralyzed from the waist down and many have limited cognitive functioning. When doctors recognize the condition, they usually perform immediate surgery to drain excess fluid and attempt to close the exposed neural tube. Specialists closely monitor a child’s condition for several weeks, providing intravenous fluids and antibiotics as needed. In many cases, experienced doctors are able to preserve the nerve fibers and allow the child to gain feeling in the legs.
Children living with myelomeningocele often face many developmental problems. The deformity can cause weakened or misshapen hips and legs, and they may have limited ability to walk and run. Physical therapy can help children learn to control fine motor skills and strengthen their legs. Speech therapy and cognitive therapy are also needed when the disorder causes brain damage. Medications for pain, swelling and inflammation are commonly prescribed to limit physiological symptoms.
As children grow, they may need to wear supportive back braces to encourage proper spinal development. They usually need regular checkups at doctor’s offices and specialty clinics to monitor their cognitive and physical development. Careful management of their condition and ongoing rehabilitation therapy can help people with myelomeningocele learn to live independently and enjoy many different activities.
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