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Myelomeningocele
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Meningomyelocele (MMC), open spinal dysraphism (OSD), spina bifida aperta, spina bifida cystica
              • Definitions

                • Posterior spinal defect lacking skin covering → neural tissue, CSF, and meninges exposed to air

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Ultrasonographic Findings

                        • Nonvascular Interventions

                          • Other Modality Findings

                            • Imaging Recommendations

                              DIFFERENTIAL DIAGNOSIS

                                PATHOLOGY

                                • General Features

                                  • Gross Pathologic & Surgical Features

                                    • Microscopic Features

                                      CLINICAL ISSUES

                                      • Presentation

                                        • Demographics

                                          • Natural History & Prognosis

                                            • Treatment

                                              DIAGNOSTIC CHECKLIST

                                              • Consider

                                                • Image Interpretation Pearls

                                                  Selected References

                                                  1. Chambers HG: Update on neuromuscular disorders in pediatric orthopaedics: duchenne muscular dystrophy, myelomeningocele, and cerebral palsy. J Pediatr Orthop. 34 Suppl 1:S44-8, 2014
                                                  2. Marreiros H et al: Who needs surgery for pediatric myelomeningocele? A retrospective study and literature review. J Spinal Cord Med. ePub, 2014
                                                  3. Mirsky DM et al: Diagnostic Features of Myelomeningocele: The Role of Ultrafast Fetal MRI. Fetal Diagn Ther. ePub, 2014
                                                  4. Adzick NS: Fetal myelomeningocele: natural history, pathophysiology, and in-utero intervention. Semin Fetal Neonatal Med. 15(1):9-14, 2010
                                                  5. Dennis M et al: The cognitive phenotype of spina bifida meningomyelocele. Dev Disabil Res Rev. 16(1):31-9, 2010
                                                  6. Bowman RM et al: The changing incidence of myelomeningocele and its impact on pediatric neurosurgery: a review from the Children's Memorial Hospital. Childs Nerv Syst. 25(7):801-6, 2009
                                                  7. Hirose S et al: Fetal surgery for myelomeningocele. Clin Perinatol. 36(2):431-8, xi, 2009
                                                  8. Saleem SN et al: Fetal MRI in the evaluation of fetuses referred for sonographically suspected neural tube defects (NTDs): impact on diagnosis and management decision. Neuroradiology. 51(11):761-72, 2009
                                                  9. Shaer CM et al: Myelomeningocele: a review of the epidemiology, genetics, risk factors for conception, prenatal diagnosis, and prognosis for affected individuals. Obstet Gynecol Surv. 62(7):471-9, 2007
                                                  10. Hirose S et al: Fetal surgery for myelomeningocele: panacea or peril? World J Surg. 27(1):87-94, 2003
                                                  11. Johnson MP et al: Fetal myelomeningocele repair: short-term clinical outcomes. Am J Obstet Gynecol. 189(2):482-7, 2003
                                                  12. 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
                                                  13. 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
                                                  14. 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
                                                  15. Bowman RM et al: Spina bifida outcome: a 25-year prospective. Pediatr Neurosurg. 34(3):114-20, 2001
                                                  16. Tortori-Donati P et al: Magnetic resonance imaging of spinal dysraphism. Top Magn Reson Imaging. 12(6):375-409, 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
                                                  19. Shurtleff DB et al: Epidemiology of tethered cord with meningomyelocele. Eur J Pediatr Surg. 7 Suppl 1:7-11, 1997
                                                  20. Shaw GM et al: Risk of neural tube defect-affected pregnancies among obese women. JAMA. 275(14):1093-6, 1996
                                                  21. McLone DG et al: Complications of myelomeningocele closure. Pediatr Neurosurg. 17(5):267-73, 1991-92
                                                  Related Anatomy
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                                                  Related Differential Diagnoses
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                                                  References
                                                  Tables

                                                  Tables

                                                  KEY FACTS

                                                  • Terminology

                                                    • Imaging

                                                      • Top Differential Diagnoses

                                                        • Pathology

                                                          • Clinical Issues

                                                            • Diagnostic Checklist

                                                              TERMINOLOGY

                                                              • Synonyms

                                                                • Meningomyelocele (MMC), open spinal dysraphism (OSD), spina bifida aperta, spina bifida cystica
                                                              • Definitions

                                                                • Posterior spinal defect lacking skin covering → neural tissue, CSF, and meninges exposed to air

                                                              IMAGING

                                                              • General Features

                                                                • Radiographic Findings

                                                                  • CT Findings

                                                                    • MR Findings

                                                                      • Ultrasonographic Findings

                                                                        • Nonvascular Interventions

                                                                          • Other Modality Findings

                                                                            • Imaging Recommendations

                                                                              DIFFERENTIAL DIAGNOSIS

                                                                                PATHOLOGY

                                                                                • General Features

                                                                                  • Gross Pathologic & Surgical Features

                                                                                    • Microscopic Features

                                                                                      CLINICAL ISSUES

                                                                                      • Presentation

                                                                                        • Demographics

                                                                                          • Natural History & Prognosis

                                                                                            • Treatment

                                                                                              DIAGNOSTIC CHECKLIST

                                                                                              • Consider

                                                                                                • Image Interpretation Pearls

                                                                                                  Selected References

                                                                                                  1. Chambers HG: Update on neuromuscular disorders in pediatric orthopaedics: duchenne muscular dystrophy, myelomeningocele, and cerebral palsy. J Pediatr Orthop. 34 Suppl 1:S44-8, 2014
                                                                                                  2. Marreiros H et al: Who needs surgery for pediatric myelomeningocele? A retrospective study and literature review. J Spinal Cord Med. ePub, 2014
                                                                                                  3. Mirsky DM et al: Diagnostic Features of Myelomeningocele: The Role of Ultrafast Fetal MRI. Fetal Diagn Ther. ePub, 2014
                                                                                                  4. Adzick NS: Fetal myelomeningocele: natural history, pathophysiology, and in-utero intervention. Semin Fetal Neonatal Med. 15(1):9-14, 2010
                                                                                                  5. Dennis M et al: The cognitive phenotype of spina bifida meningomyelocele. Dev Disabil Res Rev. 16(1):31-9, 2010
                                                                                                  6. Bowman RM et al: The changing incidence of myelomeningocele and its impact on pediatric neurosurgery: a review from the Children's Memorial Hospital. Childs Nerv Syst. 25(7):801-6, 2009
                                                                                                  7. Hirose S et al: Fetal surgery for myelomeningocele. Clin Perinatol. 36(2):431-8, xi, 2009
                                                                                                  8. Saleem SN et al: Fetal MRI in the evaluation of fetuses referred for sonographically suspected neural tube defects (NTDs): impact on diagnosis and management decision. Neuroradiology. 51(11):761-72, 2009
                                                                                                  9. Shaer CM et al: Myelomeningocele: a review of the epidemiology, genetics, risk factors for conception, prenatal diagnosis, and prognosis for affected individuals. Obstet Gynecol Surv. 62(7):471-9, 2007
                                                                                                  10. Hirose S et al: Fetal surgery for myelomeningocele: panacea or peril? World J Surg. 27(1):87-94, 2003
                                                                                                  11. Johnson MP et al: Fetal myelomeningocele repair: short-term clinical outcomes. Am J Obstet Gynecol. 189(2):482-7, 2003
                                                                                                  12. 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
                                                                                                  13. 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
                                                                                                  14. 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
                                                                                                  15. Bowman RM et al: Spina bifida outcome: a 25-year prospective. Pediatr Neurosurg. 34(3):114-20, 2001
                                                                                                  16. Tortori-Donati P et al: Magnetic resonance imaging of spinal dysraphism. Top Magn Reson Imaging. 12(6):375-409, 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
                                                                                                  19. Shurtleff DB et al: Epidemiology of tethered cord with meningomyelocele. Eur J Pediatr Surg. 7 Suppl 1:7-11, 1997
                                                                                                  20. Shaw GM et al: Risk of neural tube defect-affected pregnancies among obese women. JAMA. 275(14):1093-6, 1996
                                                                                                  21. McLone DG et al: Complications of myelomeningocele closure. Pediatr Neurosurg. 17(5):267-73, 1991-92