Myelomeningocele Management and Complications Quiz

Management and Complications of Myelomeningocele (Spina Bifida)

• In-utero repair of myelomeningocele (MM) during pregnancy reduces the need for shunting and increases the likelihood of walking without devices.
• Children with MM often experience musculoskeletal deformities such as scoliosis, kyphosis, and hip dysplasia.
• Motor level indicates the lowest intact, functional neuromuscular segment and is used to classify the severity of MM.
• High level lesions (Thoracic to L2) typically present with hip and knee contractures, scoliosis, and require assistive devices for ambulation.
• The newest classification for children with MM includes parapodium and mid to low lumbar lesions, each with specific functional abilities and ambulation requirements.
• Children with sacral lesions may walk without orthoses or upper limb support, but may experience mild to moderate gait abnormalities.
• Sensory deficits in children with MM often do not correlate with motor level and may skip levels, necessitating comprehensive testing.
• Hydrocephalus is a common co-morbidity in children with MM, often requiring ventriculoperitoneal shunting to manage fluid accumulation in the brain.
• Chiari II malformation, a deformity of the cerebellum and spinal cord, is common in children with MM and can lead to hydrocephalus.
• Cognitive and language dysfunction, latex allergy, upper limb dyscoordination, spasticity, and seizures are additional complications associated with MM.
• Surgical management for Chiari II malformation may involve posterior fossa decompression and cervical spinal laminectomy to relieve pressure on the brainstem.
• Children with MM may experience a range of complications, including cognitive dysfunction, language dysfunction, latex allergy, and upper limb dyscoordination, among others.