Myelomeningocele

Myelomeningocele: When the Backbone Takes a Twist Before Birth

Even before a baby is born, their body goes through an incredible process of development in the mother’s womb. One of the most important parts to develop during this phase is the spinal cord. Unfortunately, in some cases, this process does not complete properly as it should and leads to a condition called Myelomeningocele.

In this condition, a part of the spinal cord develops outside the baby’s body instead of being safely enclosed within the spine. This may sound alarming, but understanding this condition, its causes, and treatment can help parents feel more informed and better prepared to support their baby.

What is Myelomeningocele?

Myelomeningocele is a condition in which the baby is born with their spinal cord developing outside the body instead of inside the spine, creating a visible sac or swelling on the baby’s back. 

What happens during pregnancy? 

During pregnancy, the neural tube closes to form the brain and the spinal cord. However, in some cases, due to complications, this tube does not close completely, resulting in an exposed spinal cord without any proper protection from the bone and skin. Due to this exposure, the spinal cord becomes vulnerable to damage and severely affects the body’s functions. This condition is called Myelomeningocele. 

Why Does It Happen?

Let’s take a simple example to understand this condition: Think of the nervous system as a zipper that needs to close fully from top to bottom to function properly. But when this zipper does not close completely, especially in the lower back region, it leads to an exposed spine, and this is what we know as Myelomeningocele.

Although it is hard to know the exact cause of this condition, certain factors can increase the risk, such as:

• Inadequate intake of folic acid before and during pregnancy.
• Certain medications taken by the mother.
• Recurring high fever during early pregnancy.
• Underlying medical conditions and several genetic factors.
• Poorly controlled diabetes or obesity in the mother.

While understanding this condition, it is important to also understand that it is not caused by anything intentionally. Rather, it happens due to a mix of biological and environmental factors.

Understanding Signs of Myelomeningocele

Recognising signs and symptoms of Myelomeningocele can help in seeking timely diagnosis and treatment. While the occurrence and severity of symptoms depend on where the opening is located on the spine, here are some common Myelomeningocele symptoms that are easy to identify:

• Fluid-filled sac on the baby’s back.
• Bone and joint problems like clubfoot or hip dislocation.
• Difficulty controlling bladder and bowel movements.
• Learning difficulties in some children.
• Build-up of fluid in the brain, known as hydrocephalus.
• Weakness or paralysis in the legs.

How is Myelomeningocele Diagnosed?

Myelomeningocele is one of the conditions that can be diagnosed even before the baby’s birth. An early diagnosis during pregnancy, often between 18 and 22 weeks, allows better planning. Here’s how Myelomeningocele is usually diagnosed:

• Blood Tests

Maternal serum alpha-fetoprotein (MSAFP) is a special type of blood test that is performed to identify any unusual levels that might indicate a possible complication.

• Imaging Tests

Imaging tests such as MRI or fetal ultrasound are also performed to understand the condition better.

What Are the Treatment Options for Myelomeningocele?

Unfortunately, Myelomeningocele as a condition cannot be completely cured with treatments. However, there are several medical treatments that can significantly improve the baby’s quality of life.

Surgery for Myelomeningocele is one of the most common approaches, and it can be performed either after birth or before birth. 

• Myelomeningocele Surgery After Birth

In many cases, surgery might be performed within the first 48 hours of the baby’s birth. During the procedure, the doctors aim to close the spine and cover the exposed spinal cord. This is done to reduce the risk of infection and prevent further complications. 

• Myelomeningocele Surgery Before Birth

Performing a surgery before birth is a far more advanced but slightly risky procedure. This procedure is performed when the baby is still in the womb, between 16 to 19 weeks of pregnancy. The surgery can help improve movement in the legs and reduce the need for future treatments like shunts for hydrocephalus. In recent years, surgery before birth, also known as fetal surgery for Myelomeningocele, has shown promising results.

Why Long-Term Care and Support Matter the Most?

Dealing with Myelomeningocele is not easy for babies, and this is where the role of specialists comes into play. They are skilled professionals who can offer long term care for Myelomeningocele and the right support to help the baby live an active life. 

Usually, the care team include different types of specialists, includes:

• Neurosurgeons for brain and spine care.
• Occupational therapists and educational support professionals.
• Orthopaedic doctors for bones and joints.
• Physiotherapists to improve movement.
• Urologists for bladder issues.

The goal is to help a child become as independent as possible in terms of walking, managing daily activities, attending school comfortably, and more. 

Is Myelomeningocele Preventable?

Well, the good news is that Myelomeningocele is preventable in many cases. One of the most important ways to reduce the risk of neural tube defects is taking enough folic acid before and during early pregnancy. In many cases, doctors may recommend a daily intake of 400 µg of folic acid. However, it is crucial to seek professional advice in such cases.

A Life with Myelomeningocele

Although the condition comes with challenges, many children with Myelomeningocele grow up to lead active and fulfilling lives. With proper medical care, early intervention, and strong family support, they can go to school, build friendships, and enjoy everyday activities, despite living with Myelomeningocele.

At the same time, it is important to acknowledge that the journey can be emotionally and physically demanding. Support from healthcare professionals, family, and community plays a key role in helping both the child and parents cope better.

Final Thoughts

Myelomeningocele is more than just a condition affecting the spine, as it can influence many aspects of a baby’s life. But with early diagnosis, timely treatment, and ongoing care, life can be managed well. 

For parents planning a pregnancy, ensuring adequate folic acid intake is one of the simplest and most effective preventive steps. For families already facing this condition, remember that you are not alone. Medical professionals and the right support are available to guide you. Do not ignore any unusual signs and seek timely advice.

For more queries regarding Myelomeningocele, you can simply book a consultation at our clinic.