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Myelomeningocele

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

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

162. Fetal endoscopic myelomeningocele closure preserves segmental neurological function. Full Text available with Trip Pro

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

2011 Developmental Medicine and Child Neurology

163. Total Hip Arthroplasty in a Patient With Myelomeningocele. (Abstract)

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

164. Interrelationships of sex, level of lesion, and transition outcomes among young adults with myelomeningocele. Full Text available with Trip Pro

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.

2011 Developmental Medicine and Child Neurology

165. Kyphectomy in the treatment of patients with myelomeningocele. (Abstract)

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

166. Double myelomeningocele: case report. (Abstract)

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

167. Maldevelopment of the cerebral cortex in the surgically induced model of myelomeningocele: implications for fetal neurosurgery. Full Text available with Trip Pro

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

2011 Journal of Pediatric Surgery

168. Long-Term Urological Impact of Fetal Myelomeningocele Closure. (Abstract)

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

169. Questioning the rationale and conduct of the management of myelomeningocele study. (Abstract)

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 Controlled trial quality: uncertain

170. Open prenatal repair for open neural tube defects in the fetus

neural tube defects are those in which the affected region of the neural tube is exposed on the body's surface. The most common neural tube defect is spina bifida, where the defect is in the spine. Myelomeningocele (open spina bifida) is the most severe type of spina bifida, in which the baby's spinal canal remains open along several vertebrae in the back. The spinal cord and protective membranes around it push out and form a sac, which is exposed on the baby's back. Children born (...) with myelomeningocele may experience motor neurological deficits including muscle weakness and paralysis of the lower limbs, sensory deficit, bowel, bladder and sexual dysfunctions, and learning difficulties. The condition can be associated with Chiari II malformation (hindbrain herniation) and hydrocephalus. Current treatments Current treatments 2.2 Conventional treatment for myelomeningocele (open spina bifida) is immediate surgical repair of the defect within days of birth to prevent further damage to nervous

2020 National Institute for Health and Clinical Excellence - Interventional Procedures

171. Fetoscopic prenatal repair for open neural tube defects in the fetus

, current treatments and procedure procedure The condition The condition 2.1 Neural tube defects happen because the neural tube does not fuse during early embryonic development. Open neural tube defects are those in which the affected region of the neural tube is exposed on the body's surface. The most common neural tube defect is spina bifida where the defect is in the spine. Myelomeningocele (open spina bifida) is the most severe type of spina bifida, in which the baby's spinal canal remains open (...) along several vertebrae in the back. The spinal cord and protective membranes around it push out and form a sac which is exposed on the baby's back. Children born with myelomeningocele may experience motor neurological deficits including muscle weakness and paralysis of the lower limbs, sensory deficit, bowel, bladder and sexual dysfunctions and learning difficulties. The condition can be associated with Chiari II malformation (hindbrain herniation) and hydrocephalus. Fetoscopic prenatal repair

2020 National Institute for Health and Clinical Excellence - Interventional Procedures

172. Reducing the risk of transmission of Creutzfeldt–Jakob disease (CJD) from surgical instruments used for interventional procedures on high-risk tissues

electrodes into the spinal cord A48.8 Other specified other operations on spinal cord A49.1 Freeing of spinal tether NEC Reducing the risk of transmission of Creutzfeldt–Jakob disease (CJD) from surgical instruments used for interventional procedures on high-risk tissues (IPG666) © NICE 2020. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 15 of 18A49.2 Closure of spinal myelomeningocele A49.3 Closure of spinal meningocele A49.4

2020 National Institute for Health and Clinical Excellence - Interventional Procedures

173. Spina bifida and neural tube defects

folate supplementation or fortification. Can affect the brain (anencephaly, encephalocele) or any level of the spinal axis, although most commonly involves the lumbosacral region. Not to be confused with spina bifida occulta, which affects the vertebral arches only and is a clinically insignificant radiological finding in 10% of the general population. Defects of the spinal cord are classified as myelomeningocele when both the spine and the meninges are exposed (open) or meningocele when only (...) factors, and are prevented with folate supplementation. The most common neural tube defects include anencephaly, which affects brain and skull development and is incompatible with life, and spina bifida, which means 'split spine'. This split may be limited to the vertebral arches, known as spina bifida occulta (clinically insignificant and common, affecting 10% of the population), or associated with spine anomalies such as myelomeningocele. Spina bifida presents clinically with variable paralysis

2018 BMJ Best Practice

174. Torsion of the lower limb in children

or ensure normal gait. In otherwise healthy children, operative treatment consisting of derotational osteotomy is rarely indicated. Considered only for severe tibial rotation that does not correct by the age of 4 years and femoral malrotation that does not correct by the age of 8 years. In patients with neuromuscular disease, such as cerebral palsy or myelomeningocele, deformities may persist or worsen with time. If left untreated, these deformities may contribute to inefficient gait in ambulatory

2018 BMJ Best Practice

175. Canadian Urological Association guideline for the diagnosis, management, and surveillance of neurogenic lower urinary tract dysfunction

The International Continence Society (ICS) defines “neurogenic lower urinary tract dys - function” (NLUTD) as “lower urinary tract dysfunction due to disturbance of the neurological control mechanism.” This broad definition is used to describe a multitude of conditions of varying severity. Common causes of NLUTD include: spinal cord injury (SCI), multiple sclerosis (MS), and myelomeningocele (MMC). Other causes of NLUTD include: Parkinson’s disease, cere- brovascular accidents, traumatic brain injury, brain

2019 Canadian Urological Association

178. Spine imaging

including Chiari malformation (30%), diastematomyelia (20%), spinal segmentation anomalies and systemic developmental anomalies (VACTERL), and connective tissue disease (Marfan’s). 3 Spinal dysraphism Includes closed spinal dysraphism (lipomyelocele, lipomyelomeningocele, or dermal sinus) as well as open spinal dysraphism (meningocele, myelocele, or myelomeningocele) Advanced imaging of the spine is considered medically necessary for diagnosis and management when results of imaging will impact treatment (...) , myelomeningocele, spina bifida, and dorsal dermal sinus. 7 Ultrasound of the spine can be performed in neonates prior to ossification of the cartilaginous spine 7 and is a useful screening test in newborns and in utero, 8 helping to select patients who require further evaluation with MRI, which has higher diagnostic accuracy but is more time intensive and which may require sedation. 9 Tethered cord Advanced imaging of the spine is considered medically necessary for diagnosis and management when results

2019 AIM Specialty Health

179. Appropriate Use Criteria: Imaging of the Brain

under 5 months of age Rationale Congenital anomalies of the central nervous system can be classified 2 into disorders of dorsal/ventral induction such as myelomeningocele, holoprosencephaly, Dandy-Walker variant, or craniosynostosis, disorders of neural proliferation such as microcephaly and megalencephaly, disorders of neuronal migration such as schizencephaly and cortical heterotopias, and disorders of myelination such as adrenoleukodystrophy and Canavan disease. There are characteristic imaging

2019 AIM Specialty Health

180. The Utility and Practice of Electrodiagnostic Testing in the Pediatric Population: An AANEM Consensus Statement

demyelinating polyneuropathy 82 as well as showing abnormality in children with This article is protected by copyright. All rights reserved.Pediatric EDX Statement, page myelomeningocele 83 , children with Tourette syndrome 84 , or adolescents and adults with migraine 80 although practically it is not used for any of these conditions. While electrophysiological testing can reliably elicit R1 and R2i responses from birth, observational studies have noted that administering a shock to the glabellum reliably

2019 American Association of Neuromuscular & Electrodiagnostic Medicine

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