What is Myelomeningocele?
Myelomeningocele is a birth defect that affects a baby’s spine and spinal cord. It is the most severe form of spina bifida and is also called open spina bifida.
In this condition, the baby’s backbone and spinal canal do not close properly before birth. Because of this, a fluid-filled sac forms on the baby’s back. This sac may contain:
- Part of the spinal cord
- Spinal nerves
- Meninges (the protective covering of the spinal cord)
- Cerebrospinal fluid (CSF)
Myelomeningocele develops very early in pregnancy, usually within the first four weeks, often before a woman knows she is pregnant.
The condition most commonly affects the lower back area (lumbar or sacral spine), but it can occur anywhere along the spine.
Because the spinal cord and nerves are exposed and damaged, babies may have weakness, loss of sensation, or paralysis in the parts of the body below the affected area. In some cases, the sac may break open before or during birth, increasing the risk of infection.
What is a neural tube defect?
A neural tube defect (NTD) is a birth defect that affects the brain, spine, or spinal cord. These defects occur in the first month of pregnancy.
Normally, early in pregnancy, the baby’s neural tube closes completely and later develops into the brain and spinal cord. If this tube does not close properly, a neural tube defect occurs.
The two most common neural tube defects are:
- Spina bifida
- Anencephaly
Myelomeningocele is a type of neural tube defect.
What is the difference between spina bifida and myelomeningocele?
Spina bifida is a general term used for conditions where the spine does not close fully before birth.
Myelomeningocele is a specific and severe type of spina bifida. In this condition:
- A sac forms on the baby’s back
- The sac contains spinal cord and nerves
- Nerve damage is usually present
Other types of spina bifida include:
- Meningocele
- Spina bifida occulta (the mildest form)
What is the difference between meningocele and myelomeningocele?
Both meningocele and myelomeningocele are forms of spina bifida, but they differ in severity.
- Meningocele:
- A fluid-filled sac comes out through the spine
- The spinal cord is not inside the sac
- Nerve damage is minimal or absent
- Myelomeningocele:
- The sac contains part of the spinal cord and nerves
- Nerves are damaged
- This leads to more serious symptoms
Who can be affected by myelomeningocele?
Myelomeningocele can affect any fetus. Doctors do not know the exact cause, but certain genetic, nutritional, and environmental factors increase the risk.
What are the signs and symptoms of myelomeningocele?
The most noticeable sign is a fluid-filled sac on the baby’s back, usually in the middle or lower spine.
Doctors can often detect this condition during pregnancy using ultrasound.
Babies with myelomeningocele may also have other associated conditions, such as:
- Hydrocephalus (fluid buildup in the brain) – seen in about 8 out of 10 babies
- Syringomyelia (a fluid-filled cavity inside the spinal cord)
- Hip dislocation or other bone problems
What causes myelomeningocele?
The exact cause is unknown. Experts believe it happens due to a combination of factors, including:
- Genetics
- Environmental exposure
- Poor nutrition
One major risk factor is low folic acid levels before and during early pregnancy. Folic acid is essential for the healthy development of the baby’s brain and spine.
How is myelomeningocele diagnosed before birth?
Doctors can often detect myelomeningocele during pregnancy using the following tests:
- Blood test (AFP test): Done between 16 and 18 weeks of pregnancy. High levels of alpha-fetoprotein (AFP) may suggest spina bifida.
- Prenatal ultrasound: This is the most accurate test. Myelomeningocele is usually diagnosed during the second-trimester ultrasound (18–22 weeks).
- Amniocentesis: In some cases, doctors may recommend this test to rule out genetic conditions. It involves taking a small sample of fluid from around the baby.
If myelomeningocele is not diagnosed before birth, imaging tests like MRI or CT scans may be used after birth.
What is the treatment for myelomeningocele?
The main treatment is surgery to close the opening in the spine.
This surgery can be done:
- Before birth (fetal surgery)
- After birth (postnatal surgery)
Many babies also develop hydrocephalus and may need a VP shunt, a small tube that drains excess fluid from the brain.
Long-term care may include:
- Physical therapy
- Treatment for bladder or bowel problems
- Medicines to prevent infections
Fetal surgery for myelomeningocele
In selected cases, surgery can be performed during pregnancy.
This may help prevent the condition from getting worse, but it cannot reverse nerve damage that has already occurred.
Fetal surgery carries risks, including:
- Early delivery
- Complications related to the uterus
Postnatal surgery for myelomeningocele
If fetal surgery is not done, the baby usually needs surgery within the first 48 hours after birth to reduce the risk of infection and further damage.
Which doctors will care for a child with myelomeningocele?
Care usually involves a team of specialists, including:
- Neurologist
- Neurosurgeon
- Urologist
- Orthopaedic doctor
- Physical therapist
- Dermatologist
What is the long-term outlook for myelomeningocele?
The outcome varies from child to child and depends on:
- The level of the spine affected
- Severity of nerve damage
- Timing of surgery
Children with higher spinal involvement usually have more severe symptoms.
People with spina bifida may face ongoing health challenges and require lifelong care. Emotional and mental health support is also important, as anxiety and depression are more common.
What are the possible complications?
The common complications include:
- Paralysis or loss of sensation
- Difficulty walking
- Bladder and bowel control problems
- Frequent urinary infections
- Spine and joint deformities
- Learning difficulties
- Seizures
- Latex allergy
What are the risk factors for myelomeningocele?
Myelomeningocele cannot always be prevented, but the risk can be reduced. Risk factors include:
- Low folic acid intake
- Family history of neural tube defects
- Use of certain anti-seizure medicines during pregnancy
- Poorly controlled diabetes
- Obesity before pregnancy
- High body temperature early in pregnancy (fever, hot tubs, saunas)
It’s important to understand that having a baby with myelomeningocele is not anyone’s fault.
How can parents care for a child with myelomeningocele?
Every child is affected differently. It’s not possible to predict the exact challenges your baby may face.
The best step is to work closely with experienced healthcare providers and follow a long-term care plan that supports your child’s physical, emotional, and developmental needs.
With proper medical care and support, many children with myelomeningocele can lead meaningful and fulfilling lives.
Why choose Tender Palm Super-Speciality Hospital for Myelomeningocele treatment for children in Lucknow, India?
Tender Palm Super-Speciality Hospital offers advanced Myelomeningocele treatment for children in Lucknow, India, at an affordable cost. We have a team of experienced pediatric neurosurgeons and spinal specialists who provide accurate diagnosis with advanced imaging, personalized medical care, and specialized surgical treatment tailored to each child's specific condition. Our Pediatric Neurosurgery team has decades of experience in successfully treating Myelomeningocele in Lucknow, India.
To seek an Expert Consultation for Myelomeningocele treatment for children in Lucknow, India:
Call us at +91-9076972161
Email at care@tenderpalm.com
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