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Myelomeningocele

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121. Poland syndrome with extracorporeal intercostal liver herniation and thoracic myelomeningocele. (PubMed)

Poland syndrome with extracorporeal intercostal liver herniation and thoracic myelomeningocele. Poland syndrome is characterized by hypoplastic unilateral chest wall structures. These chest wall deformities may be associated with upper extremity anomalies. The association of Poland syndrome with either intercostal liver herniation or a spinocerebral deformity has been described, but there is no report of both findings encountered simultaneously. This is the first report of a newborn child (...) with Poland syndrome associated with an intercostal liver segment herniation and thoracic myelomeningocele with features of an Arnold-Chiari II cerebral malformation.Copyright © 2012 Elsevier Inc. All rights reserved.

2012 Journal of Pediatric Surgery

122. Evaluating the cost-effectiveness of prenatal surgery for myelomeningoceles: a decision analysis. (PubMed)

Evaluating the cost-effectiveness of prenatal surgery for myelomeningoceles: a decision analysis. To determine whether prenatal myelomeningocele repair is a cost-effective strategy compared to postnatal repair.Decision-analysis modeling was used to calculate the cumulative costs, effects and incremental cost-effectiveness ratio of prenatal myelomeningocele repair compared with postnatal repair in singleton gestations with a normal karyotype that were identified with myelomeningocele between T1 (...) and S1. The model accounted for costs and quality-adjusted life years (QALYs) in three populations: (1) myelomeningocele patients; (2) mothers carrying myelomeningocele patients; and (3) possible future siblings of these patients. Sensitivity analysis was performed using one-way, two-way and Monte Carlo simulations.Prenatal myelomeningocele repair saves $ 2 066 778 per 100 cases repaired. Additionally, prenatal surgery results in 98 QALYs gained per 100 repairs with 42 fewer neonates requiring shunts

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2012 Ultrasound in Obstetrics and Gynecology

123. Upper and lower urinary tract outcomes in adult myelomeningocele patients: a systematic review. (PubMed)

Upper and lower urinary tract outcomes in adult myelomeningocele patients: a systematic review. The introduction of sophisticated treatment of bladder dysfunction and hydrocephalus allows the majority of SB patients to survive into adulthood. However, no systematic review on urological outcome in adult SB patients is available and no follow-up schemes exist.To systematically summarize the evidence on outcome of urinary tract functioning in adult SB patients.A literature search in PubMed

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2012 PloS one

124. Functional Significance of Atypical Cortical Organization in Spina Bifida Myelomeningocele: Relations of Cortical Thickness and Gyrification with IQ and Fine Motor Dexterity (PubMed)

Functional Significance of Atypical Cortical Organization in Spina Bifida Myelomeningocele: Relations of Cortical Thickness and Gyrification with IQ and Fine Motor Dexterity The cortex in spina bifida myelomeningocele (SBM) is atypically organized, but it is not known how specific features of atypical cortical organization promote or disrupt cognitive and motor function. Relations of deviant cortical thickness and gyrification with IQ and fine motor dexterity were investigated in 64 individuals

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2012 Cerebral Cortex (New York, NY)

125. Myelomeningocele

Myelomeningocele Myelomeningocele Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Myelomeningocele Myelomeningocele Aka (...) : Myelomeningocele , Severe Spina Bifida From Related Chapters II. Epidemiology Occurs in 1 per 1000 live births III. Risk Factors Maternal Prior history of child with Myelomeningocele (4% risk) (1-2% risk if taken during pregnancy) IV. Pathophysiology Severe form of Affects lumbosacral region in 75% of cases Associated with dysfunction of multiple organ systems V. Signs of lower extremities es absent VI. Associated Conditions (80% of cases) Neurogenic VII. Management Supportive care may be appropriate in severe

2015 FP Notebook

126. In Utero Closure of Myelomeningocele Does Not Improve Lower Urinary Tract Function. (PubMed)

In Utero Closure of Myelomeningocele Does Not Improve Lower Urinary Tract Function. Recent data comparing prenatal to postnatal closure of myelomeningocele showed a decreased need for ventriculoperitoneal shunting and improved lower extremity motor outcomes in patients who underwent closure prenatally. A total of 11 children whose spinal defect was closed in utero were followed at our spina bifida center. We hypothesized that in utero repair of myelomeningocele improves lower urinary tract (...) between catheterizations or anticholinergic/antibiotic use. Urodynamic parameters including bladder capacity, detrusor pressure at capacity, detrusor overactivity and the presence of detrusor sphincter dyssynergia were not significantly different between the groups. There was no difference in the rate of ventriculoperitoneal shunting (p = 0.14) or untethering surgery (p = 0.99).While in utero closure of myelomeningocele has been shown to decrease rates of ventriculoperitoneal shunting and improve

2012 Journal of Urology

127. Editorial: Myelomeningocele (PubMed)

Editorial: Myelomeningocele 21246312 2011 06 07 2018 11 13 1528-1132 469 5 2011 May Clinical orthopaedics and related research Clin. Orthop. Relat. Res. Editorial: myelomeningocele. 1223-4 10.1007/s11999-011-1776-3 Segal Lee S LS eng Editorial Introductory Journal Article United States Clin Orthop Relat Res 0075674 0009-921X AIM IM Child Child, Preschool Humans Infant Interdisciplinary Communication Meningomyelocele Patient Care Team Spinal Dysraphism 2011 1 20 6 0 2011 1 20 6 0 2011 6 8 6 0

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2011 Clinical Orthopaedics and Related Research

128. Kyphectomy for severe kyphosis with pyogenic spondylitis associated with myelomeningocele: a case report (PubMed)

Kyphectomy for severe kyphosis with pyogenic spondylitis associated with myelomeningocele: a case report A 32-year-old woman was referred to our hospital for a refractory ulcer on her back. She had a history of myelomeningocele with spina bifida that was treated surgically at birth. The ulcer was located at the apex of the kyphosis. An X-ray film revealed a kyphosis of 154° between L1 and 3 and a scoliosis of 60° between T11 and L5. Computed tomography, magnetic resonance imaging

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2011 Scoliosis

129. Questioning the rationale and conduct of the management of myelomeningocele study. (PubMed)

Questioning the rationale and conduct of the management of myelomeningocele study. Surgical intervention in fetal spina bifida developed from the belief that amniotic fluid damages the spinal cord in utero and low spinal pressure from failure of neural tube closure causes hindbrain herniation leading to hydrocephalus after birth for many infants with open spinal lesions. Intrauterine intervention is undergoing a randomised human trial known by the acronym MOMS. It is hoped that randomisation

2011 Medical hypotheses

130. Maldevelopment of the cerebral cortex in the surgically induced model of myelomeningocele: implications for fetal neurosurgery. (PubMed)

Maldevelopment of the cerebral cortex in the surgically induced model of myelomeningocele: implications for fetal neurosurgery. The purpose of this study is to describe the malformations of cortical development detected in a model of cerebrospinal fluid (CSF) leakage and the influence of surgical closure technique on developmental outcome.Using a surgically induced model of myelomeningocele (MMC) in sheep, we studied the effects of different repair methods upon the development of hydrocephalus

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2011 Journal of Pediatric Surgery

131. Double myelomeningocele: case report. (PubMed)

Double myelomeningocele: case report. Double myelomeningocele is very rare, with only a few cases are published in the world's literature. The mechanism of this form of neural tube defects constitutes a challenging problem. The authors present an unusual case of a 3 month-old child, with two myelomeningoceles, one at the cervical level and the other at the lumbar level, without hydrocephalus or Chiari malformation.

2011 British Journal of Neurosurgery

132. Prenatal repair of myelomeningocele with aligned nanofibrous scaffolds-a pilot study in sheep. (PubMed)

Prenatal repair of myelomeningocele with aligned nanofibrous scaffolds-a pilot study in sheep. Spinal cord damage in myelomeningocele (MMC) results from abnormal cord development and subsequent local trauma. Prenatal surgery prevents additional neural injury. However, existing damage is not reversed. Biodegradable nanofibrous scaffolds (NSs) promote regeneration of neural tissues. They mimic the microtopography of the extracellular matrix and guide tissue formation and organization. The purpose

2011 Journal of Pediatric Surgery

133. Total Hip Arthroplasty in a Patient With Myelomeningocele. (PubMed)

Total Hip Arthroplasty in a Patient With Myelomeningocele. The pathophysiology of hip subluxation and advanced arthritic changes in patients with myelomeningocele is usually due to a muscle imbalance between intact hip flexor and adductor muscles and weak gluteal and abductor muscles. Operative options include resection arthroplasty, hip arthrodesis, and total hip arthroplasty (THA). Each option has been reported to be fraught with complications. Previous reports of THA in these patients have (...) largely been unsuccessful with catastrophic failures characterized by instability and early loosening. We report a case of a 46-year-old woman with L4 level myelomeningocele with a neurogenic dysplastic advanced arthritic left hip with subluxation. She underwent a successful THA with unique combination of implants that allowed for maximal options in this challenging clinical situation.Copyright © 2012 Elsevier Inc. All rights reserved.

2011 Journal of Arthroplasty

134. Fetal endoscopic myelomeningocele closure preserves segmental neurological function. (PubMed)

Fetal endoscopic myelomeningocele closure preserves segmental neurological function.   Our aim was to compare the effect of prenatal endoscopic with postnatal myelomeningocele closure (fetally operated spina bifida aperta [fSBA]) versus neonatally operated spina bifida aperta [nSBA]) on segmental neurological leg condition.  Between 2003 and 2009, the fetal surgical team (Department of Obstetrics, University of Bonn, Germany) performed 19 fetal endoscopic procedures. Three procedures resulted (...) myotomes caudal and cranial to the myelomeningocele (reflecting neuromuscular damage by the myelomeningocele) and compared dMUD between fSBA and nSBA infants. Finally, we correlated dMUD with segmental neurological function.  We found that, on average, the fSBA group were born at a lower gestational age than the nSBA group (median 32 wks [range 25-34 wks] vs 39 wks [34-41 wks]; p=0.001) and experienced more complications (chorioamnionitis, premature rupture of the amniotic membranes, oligohydramnios

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2011 Developmental Medicine and Child Neurology

135. Kyphectomy in the treatment of patients with myelomeningocele. (PubMed)

Kyphectomy in the treatment of patients with myelomeningocele. Myelomeningocele kyphosis is a complex disorder that usually requires surgical intervention. Many complications can occur as a result of this disorder and its treatment, but only surgical correction offers the possibility of restoring spinal alignment.The purpose of this retrospective study was to summarize the surgical results, complications, and short-term and midterm outcomes for surgical correction of severe kyphosis using (...) a consistent surgical technique.This was a retrospective review of our database of pediatric patients with myelomeningocele and lumbar kyphosis who underwent kyphectomy with the use of the Warner and Fackler technique.Eleven pediatric kyphectomy cases performed by a single surgeon from 1984 to 2009 were reviewed.Outcome measures include imaging, kyphotic angle measurement, and physical examination.Patients underwent the Warner and Fackler technique of posterior-only kyphectomy and bayonet-shaped anterior

2011 The Spine Journal

136. Interrelationships of sex, level of lesion, and transition outcomes among young adults with myelomeningocele. (PubMed)

Interrelationships of sex, level of lesion, and transition outcomes among young adults with myelomeningocele. To advance understanding of the interrelationships of sex, level of lesion (LOL), self-management, community integration (employment, independent living), and quality of life (QOL) in young adults with myelomeningocele.A multicenter convenience sample of 50 individuals with myelomeningocele, 18 to 25 years of age (mean age 21 y 5 mo, SD 2 y), participated in a structured clinical (...) observed.The overall low rates of employment and independent living suggest that individuals with myelomeningocele are experiencing great difficulty in achieving these milestones of emerging adulthood, regardless of sex. Limited success in developing self-management skills and restricted QOL also highlight vulnerability in this population.© The Authors. Developmental Medicine & Child Neurology © 2011 Mac Keith Press.

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2011 Developmental Medicine and Child Neurology

137. A rare case of anterior thoracic myelomeningocele with scoliosis-case report and review of the literature. (PubMed)

A rare case of anterior thoracic myelomeningocele with scoliosis-case report and review of the literature. Spinal deformities associated with spinal dysraphism are a challenging problem. Myelomeningocele has been reported in the lumbar spine. However, it is rare in the thoracic spine.The purpose of the report was to heighten the awareness of the rare presentation of the myelomeningocele in the thoracic spine and the ability to correct the scoliosis without debulking the lesion.This (...) is a clinical case report and literature review.We report a 13-year-old girl presented with complaints of back pain, difficulty in breathing, and easy fatigability. On examination, she had a thoracolumbar scoliosis, weakness of the right ankle dorsiflexors, and impaired sensation over the L5 dermatome of the right lower limb. Radiographic examination revealed a 128° thoracolumbar scoliosis with congenital hemivertebra at T6-T9, block vertebrae of T4 and T5, and intrathoracic myelomeningocele. She underwent

2011 The Spine Journal

138. Amniotic fluid levels of glial fibrillary acidic protein in fetal rats with retinoic acid induced myelomeningocele: a potential marker for spinal cord injury. (PubMed)

Amniotic fluid levels of glial fibrillary acidic protein in fetal rats with retinoic acid induced myelomeningocele: a potential marker for spinal cord injury. The objective of this study was to determine whether amniotic fluid levels of glial acidic fibrillary protein (GFAP) would reflect myelomeningocele-related neurodegeneration in the rat model of retinoic acid-induced myelomeningocele, which is a model that is very similar to human myelomeningocele and develops the entire spectrum (...) of disease severity including features of the Chiari II malformation.Time-dated (embryonic day 10) pregnant Sprague-Dawley rats were gavage fed 60 mg/kg/bodyweight retinoic acid that had been dissolved in olive oil or olive oil alone. Myelomeningocele, retinoic acid-exposed no myelomeningocele, and control fetuses were harvested at specific time points throughout gestation. A standard set of pinching tests was performed to interrogate the sensorimotor reflex arc of hindpaws and tails. Amniotic fluid-GFAP

2011 American Journal of Obstetrics and Gynecology

139. Long-Term Urological Impact of Fetal Myelomeningocele Closure. (PubMed)

Long-Term Urological Impact of Fetal Myelomeningocele Closure. Between 1997 and 2002 a large number of fetal myelomeningocele closures were performed at our institution. Previously early reports showed little improvement in neonatal bladder function after fetal back closure. We evaluated the long-term urological impact of this procedure.Using a combination of retrospective review and survey questionnaire we reviewed the records of 28 patients in whom fetal myelomeningocele closure was done (...) at our institution between 1997 and 2002. The areas addressed included medical management for neurogenic bladder and bowel, need for lower urinary tract reconstruction and functional bladder assessment by videourodynamics. Parameters after fetal myelomeningocele closure were compared to those of 33 age and sex matched patients with myelomeningocele who underwent standard postnatal closure.We reviewed the records of 28 patients after fetal myelomeningocele closure. At a mean age of 9.6 years 23 used

2011 Journal of Urology

140. Urological outcome after myelomeningocele: 20 years of follow-up. (PubMed)

Urological outcome after myelomeningocele: 20 years of follow-up. • To evaluate the urological outcome in a long-term follow-up of individuals with myelomeningocele and relate the findings obtained to urodynamic variables in childhood.• Individuals with myelomeningocele born from 1964-1988 were included at time of urodynamic investigation. • Age at inclusion was in the range from 1 month to 19.5 years (median, 6 years). • Detrusor function was classified as overactive, underactive or non (...) %) had deteriorated kidney function. • Adult individuals with bilateral kidney deterioration had a significant higher frequency of diagnosed detrusor overactivity at childhood urodynamics (63%) compared to those with normal function of both kidneys (24%). In total, 48% of the 52 myelomeningocele individuals were continent at follow-up. • Continence surgery was performed in eight patients, nine used anticholinergica, three had regular botulinum toxin detrusor injections, and 27 used clean intermittent

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2011 BJU international

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