Myelomeningocele - A literature review

Spina Bifida is the most common congenital abnormality of the central nervous system that is compatible with life. The various phenotypic variations in the expression of spina bifida may be classified anatomically or embryologically. Myelomeningocele is the most common anatomical type off spina bifida comprised approximately 85% of lesions. In terms of individuals born with a myelomeningocele variations in gender distribution are also seen depending on the geographical region being considered. The strongest established clusters of risk factors for the development of a myelomeningocele are genetic and dietary. Current prenatal screenings with alpha fetoprotein and ultrasonography have allowed prenatal diagnosis of a neural tube defect. The clinical manifestation of spina bifida depends on the clinical type and severity. With regards myelomeningocele the presentation is commonly a midline anomaly in the lumbosacral region. While commonly lumbosacral the anatomical location of myelomeningocele varies. There are additional anomalies associated with myelomeningoceles. While only 10% of neonates have clinically apparent hydrocephalus at birth within the first week of life this incidence sharply increases and hydrocephalus manifests in up to 85% of cases. In addition almost all patients with myelomeningocele have the Arnold Chiari 2 malformation. While surgical closure of myelomeningoceles is traditionally done postnatally within the first 48 h of life, the advent of the ability to perform relatively safe fetal surgical closure has noted considerable advantages. We conducted a PubMed search on the topic of myelomeningoceles and this review explores the topic of myelomeningocele based on the broad considerations taken from the various papers considered.