Myelomeningocele (Patient Information)

A myelomeningocele is a sac that bulges through an opening in the lower back (spina bifida) and contains CSF (spinal fluid), spinal cord, and nerves. It is the most common form of spina bifida, occurring in 1 out of 500 births.
What causes this?
No one knows for certain though research points to possible genetic and/or environmental factors. This problem develops during the first month of pregnancy, usually before the mother realizes she is pregnant. Nothing either parent has done/not done is related to causing a myelomeningocele.

What will be the effects on my child?
  • Little or no muscle function of the legs: usually the nerves and spinal cord in the sac are abnormal, causing partial or total paralysis in the legs. Generally, the higher the spinal defect, the more likely there will be paralysis.
  • With lack of sensation in the lower body and legs: inability to feel heat, cold, pressure, or pain impairs the body's warning system.
  • Inability to control urination or bowel movements: the nerves which control bladder and bowel extend from the lower end of the spinal cord; almost all spina bifidas occur at this level or higher.
  • Hydrocephalus: this occurs in approximately 9 out of 10 children with spina bifida. It is caused by a block in the normal circulation of CSF within and around the brain and causes an increase in head size.
What is the treatment for myelomeningocele?
A dressing will be placed over the sac on the baby's back to protect it until the baby goes to surgery. Surgery will be done usually within the first 24-48 hours after birth, if there are no complications that might interfere. Early surgery helps prevent infection and further damage due to handling/trauma.
After surgery, your baby will have a bandage covering the surgical site. The baby will be positioned on their stomach most of the time to protect the surgical site until it is healed. When the baby begins feeding, he/she should be supported so that pressure is kept off the dressing.
Your baby will be watched closely for any complications, including hydrocephalus, infection, and possible leakage of spinal fluid through the repair. Urination and stooling patterns will also be watched closely. A physical therapist will evaluate your baby to see how well they can move the muscles that controls the legs and arms. The therapist will teach you exercises you can do for your baby to strengthen the muscles and to prevent their legs from becoming stiff.