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Myelomeningocele
Usha D. Nagaraj, MD
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Meningomyelocele, open spinal dysraphism (OSD)
            • Definitions

              • Myelomeningocele (MMC): Open (lacking skin covering) spinal dysraphism in which neural placode (exposed flattened end of elongated spinal cord) protrudes beyond skin surface dorsal to spinal canal

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Caldarelli M et al: Recurrent tethered cord: radiological investigation and management. Childs Nerv Syst. 29(9):1601-9, 2013
                                          2. Messing-Jünger M et al: Primary and secondary management of the Chiari II malformation in children with myelomeningocele. Childs Nerv Syst. 29(9):1553-62, 2013
                                          3. Sweeney KJ et al: Spinal level of myelomeningocele lesion as a contributing factor in posterior fossa volume, intracranial cerebellar volume, and cerebellar ectopia. J Neurosurg Pediatr. 11(2):154-9, 2013
                                          4. Barkovich AJ et al: Pediatric Neuroimaging. 5th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. 863-70, 2012
                                          5. Jernigan SC et al: Risk factors of sudden death in young adult patients with myelomeningocele. J Neurosurg Pediatr. 9(2):149-55, 2012
                                          6. Adzick NS et al: A randomized trial of prenatal versus postnatal repair of myelomeningocele. N Engl J Med. 364(11):993-1004, 2011
                                          7. Chao TT et al: Fetal spine findings on MRI and associated outcomes in children with open neural tube defects. AJR Am J Roentgenol. 197(5):W956-61, 2011
                                          8. Adzick NS: Fetal myelomeningocele: natural history, pathophysiology, and in-utero intervention. Semin Fetal Neonatal Med. 15(1):9-14, 2010
                                          9. Rufener SL et al: Congenital spine and spinal cord malformations--pictorial review. AJR Am J Roentgenol. 194(3 Suppl):S26-37, 2010
                                          10. Hirose S et al: Fetal surgery for myelomeningocele. Clin Perinatol. 36(2):431-8, xi, 2009
                                          11. Hirose S et al: Fetal surgery for myelomeningocele: panacea or peril? World J Surg. 27(1):87-94, 2003
                                          12. Johnson MP et al: Fetal myelomeningocele repair: short-term clinical outcomes. Am J Obstet Gynecol. 189(2):482-7, 2003
                                          13. Ertl-Wagner B et al: Fetal magnetic resonance imaging: indications, technique, anatomical considerations and a review of fetal abnormalities. Eur Radiol. 12(8):1931-40, 2002
                                          14. Rintoul NE et al: A new look at myelomeningoceles: functional level, vertebral level, shunting, and the implications for fetal intervention. Pediatrics. 109(3):409-13, 2002
                                          15. Trivedi J et al: Clinical and radiographic predictors of scoliosis in patients with myelomeningocele. J Bone Joint Surg Am. 84-A(8):1389-94, 2002
                                          16. Bowman RM et al: Spina bifida outcome: a 25-year prospective. Pediatr Neurosurg. 34(3):114-20, 2001
                                          17. Tortori-Donati P et al: Spinal dysraphism: a review of neuroradiological features with embryological correlations and proposal for a new classification. Neuroradiology. 42(7):471-91, 2000
                                          18. Unsinn KM et al: US of the spinal cord in newborns: spectrum of normal findings, variants, congenital anomalies, and acquired diseases. Radiographics. 20(4):923-38, 2000
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Synonyms

                                                      • Meningomyelocele, open spinal dysraphism (OSD)
                                                    • Definitions

                                                      • Myelomeningocele (MMC): Open (lacking skin covering) spinal dysraphism in which neural placode (exposed flattened end of elongated spinal cord) protrudes beyond skin surface dorsal to spinal canal

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • CT Findings

                                                          • MR Findings

                                                            • Ultrasonographic Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Gross Pathologic & Surgical Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Caldarelli M et al: Recurrent tethered cord: radiological investigation and management. Childs Nerv Syst. 29(9):1601-9, 2013
                                                                                  2. Messing-Jünger M et al: Primary and secondary management of the Chiari II malformation in children with myelomeningocele. Childs Nerv Syst. 29(9):1553-62, 2013
                                                                                  3. Sweeney KJ et al: Spinal level of myelomeningocele lesion as a contributing factor in posterior fossa volume, intracranial cerebellar volume, and cerebellar ectopia. J Neurosurg Pediatr. 11(2):154-9, 2013
                                                                                  4. Barkovich AJ et al: Pediatric Neuroimaging. 5th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. 863-70, 2012
                                                                                  5. Jernigan SC et al: Risk factors of sudden death in young adult patients with myelomeningocele. J Neurosurg Pediatr. 9(2):149-55, 2012
                                                                                  6. Adzick NS et al: A randomized trial of prenatal versus postnatal repair of myelomeningocele. N Engl J Med. 364(11):993-1004, 2011
                                                                                  7. Chao TT et al: Fetal spine findings on MRI and associated outcomes in children with open neural tube defects. AJR Am J Roentgenol. 197(5):W956-61, 2011
                                                                                  8. Adzick NS: Fetal myelomeningocele: natural history, pathophysiology, and in-utero intervention. Semin Fetal Neonatal Med. 15(1):9-14, 2010
                                                                                  9. Rufener SL et al: Congenital spine and spinal cord malformations--pictorial review. AJR Am J Roentgenol. 194(3 Suppl):S26-37, 2010
                                                                                  10. Hirose S et al: Fetal surgery for myelomeningocele. Clin Perinatol. 36(2):431-8, xi, 2009
                                                                                  11. Hirose S et al: Fetal surgery for myelomeningocele: panacea or peril? World J Surg. 27(1):87-94, 2003
                                                                                  12. Johnson MP et al: Fetal myelomeningocele repair: short-term clinical outcomes. Am J Obstet Gynecol. 189(2):482-7, 2003
                                                                                  13. Ertl-Wagner B et al: Fetal magnetic resonance imaging: indications, technique, anatomical considerations and a review of fetal abnormalities. Eur Radiol. 12(8):1931-40, 2002
                                                                                  14. Rintoul NE et al: A new look at myelomeningoceles: functional level, vertebral level, shunting, and the implications for fetal intervention. Pediatrics. 109(3):409-13, 2002
                                                                                  15. Trivedi J et al: Clinical and radiographic predictors of scoliosis in patients with myelomeningocele. J Bone Joint Surg Am. 84-A(8):1389-94, 2002
                                                                                  16. Bowman RM et al: Spina bifida outcome: a 25-year prospective. Pediatr Neurosurg. 34(3):114-20, 2001
                                                                                  17. Tortori-Donati P et al: Spinal dysraphism: a review of neuroradiological features with embryological correlations and proposal for a new classification. Neuroradiology. 42(7):471-91, 2000
                                                                                  18. Unsinn KM et al: US of the spinal cord in newborns: spectrum of normal findings, variants, congenital anomalies, and acquired diseases. Radiographics. 20(4):923-38, 2000