Symptoms, examination and treatment of spina bifida

Spina bifida occurs in newborn babies and is a serious genetic disease. According to the physiological explanation, the spine supporting the human body is composed of 26 vertebrae, and the lumen in the center of the spine is called spinal canal. The tube contains spinal cord, nerve and spinal cord. Spina bifida is common in lumbosacral region and occasionally in chest. Most of the defects are located in the back of the spine, and very few are located in the front. Regarding spina bifida, Professor Yan Yi from the Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University made the following explanation.

Symptoms of various spina bifida:

1. spina bifida occulta: This deformity is very common, but the spinal canal is defective, and the spinal cord itself is normal, with no neurological symptoms and no impact on health. 20-25% of normal people have spina bifida, and some children often have some abnormal phenomena on the defective skin, such as a pinch of hair, pits, vascular nevus, pigmentation, subcutaneous fat thickening and so on. There may also be congenital cysts or lipomas at the defect.

2.

Spina bifida with meningocele: There is a cyst in the spinal defect, mostly in the lumbosacral region. The tumor is round and may be very large, with only cerebrospinal fluid and cerebrospinal fluid, but no spinal cord and other nerve tissues. Children with simple meningocele have no neurological symptoms. If the skin outside the cyst wall is normal, the tumor is rarely infected. If the cyst wall is thin or ruptured, cerebrospinal fluid leakage or infection often occurs.

3. Spina bifida with meningocele of spinal cord: it mostly occurs in lumbosacral region and also can be seen in back. The tumor is round and contains nerve tissue besides cerebrospinal fluid and cerebrospinal fluid. The tumor is covered with thin skin, and the central area may only have translucent meninges. Dysplasia of spinal cord, nerve, spinal cord membrane and vertebral muscle is often connected with skin. Some children's spinal cord herniation has neither capsule nor skin coverage, which shows the deformity of spinal cord valgus.

4. Other malformations: spina bifida may be accompanied by some rare malformations, such as hydrocephalus in spinal cord (1): it mostly occurs in thoracic vertebrae, thoracolumbar or lumbosacral regions, with a large amount of fluid remaining in the central spinal canal and only atrophic spinal cord tissue in the capsule. (2) Amnesia: The immature spinal cord is often accompanied by anencephaly and dies soon after birth. (3) dermoid cyst, lipoma or teratoma tissue: it can invade the dura mater or spinal cord. Common deformities coexisting with spina bifida include hydrocephalus, deformed foot, meningeal or encephalocele, cleft lip and congenital heart disease.

Examination of spina bifida:

When the mother finds that the newborn's body is cold, hard and swollen, she needs to consider whether she has spina bifida. The mother can take the newborn to the hospital for examination to confirm whether it has become ill. The examination methods of neonatal spina bifida include X-ray photograph, light transmission test, CT or MR, etc.

1.x-ray photos: By taking X-ray photos of the newborn, it can be shown whether the newborn has spinal canal malformation, spinous process and lamina defect.

2. Tumor light transmission test: If the content is cerebrospinal fluid, it is uniform light transmission, and if it is spinal cord or fat, it is opaque.

3.CT or MR: Computed tomography (CT) or magnetic resonance imaging (MR) of the corresponding mass shows that the mass communicates with the spinal canal through a fissure, which can be cerebrospinal fluid or spinal nerve.

Treatment of neonatal spina bifida;

1. asymptomatic recessive spina bifida does not need treatment.

2. Surgical therapy

(1) The capsule wall is very thin, the capsule cavity is rapidly enlarged, and it may rupture or has ruptured at any time, but there is no infection, so surgery should be performed as soon as possible.

(2) If the cyst wall is thick, the lump is not big, and the activity of both lower limbs is good, surgery can be performed when the baby is old enough to tolerate surgery.

(3) Simple operation to remove cysts in infancy still leads to urinary and lower limb dysfunction. If the local skin is still normal, we should still try to have another operation.

(4) Burst infection of cyst wall, or severe neurological dysfunction in early stage, accompanied by hydrocephalus and severe mental decline.

The general surgical principles are mass resection, nerve release and decompression of spinal canal, and the swollen nerve tissue is reintegrated into the spinal canal to repair soft tissue defects, so as to avoid permanent involvement of nerve tissue and aggravate symptoms. Postoperative dressing should be strict, and prone position or lateral position should be adopted within 2-3 days after operation and suture removal to prevent urine and urine from soaking and polluting the incision.

After reading Professor Yan Yi's explanation of neurosurgery in the First Affiliated Hospital of Chongqing Medical University, have you understood all this knowledge? I hope everyone can pay attention to it, especially new mothers must pay more attention to their children's physical changes. If they have the above symptoms, they should go to a regular hospital for neurosurgical examination and treatment.