Pediatric
Open spina bifida (myelomeningocele)
Also called: myelomeningocele, spina bifida aperta
Open spina bifida, most often myelomeningocele, is a neural tube defect in which the spinal cord is exposed at birth. Most affected children need lifelong care, often including a CSF shunt.
Open spina bifida is a birth defect in which the neural tube fails to close, leaving part of the spinal cord and its coverings exposed. Myelomeningocele is the most common and most severe form. The level of the lesion largely determines leg strength, sensation, and bladder and bowel function.
Most children with myelomeningocele also develop hydrocephalus, and many are treated with a cerebrospinal fluid (CSF) shunt that may need revision over a lifetime. Chiari II malformation is also common. Folic acid before conception lowers the risk of neural tube defects, and prenatal repair is an option in selected pregnancies.
Survival into adulthood is now usual, which shifts attention to long-term outcomes such as frailty, independence and survival into middle age.
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Educational reference. Not medical advice and not for clinical decision-making.