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1. 5 Major Spina Bifida
Neurosurgical Issues
Spina Bifida Educational Resource
http://www.spinabifida.net

2. What does “Spina Bifida” mean?
• Multiple related disorders
• Name refers to appearance on plain
Xray: bifid (=split) spine
• All involve failure of the neural tube to
disconnect from the skin, form a tube,
and close correctly

3. What does “Spina Bifida” mean?
• Some skin-covered and some not
• If not skin-covered, associated with
brain malformation (Chiari II)

4. Closure of
Neural Tube
1. Sheet of ectoderm
2. Neural “groove”
forms down center
3. Edges come together
as a tube
4. Future spinal cord
breaks away from skin

5. Types of Spina Bifida
• Spina bifida aperta aka”open”
• Myelomeningocele (MM)
• Most common permanently disabling birth
defect in US
• Most common non-lethal CNS birth defect
• Cord non-functional at and below lesion
• Focus of today’s talk

6. Spina Bifida Aperta
• Decreased incidence last 50 years
• Incidence 3.2/10,000 births
• Likely due to many factors:
• Maternal nutrition
• Folate
• Prenatal diagnosis/selective
termination

7. Spina Bifida Aperta
Myelomeningocele

8. Small Neural Placode

9. Large Myelomeningocele Sac

10. Intra-op View

11. Don’t forget the basics!

12. Any Questions?
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