Meningomyelocele is a type of neural tube defect that results from incomplete closure of the posterior spine during early development.
The visible mass contains dysplastic spinal cord as well as meninges, nerve roots, and CSF.
As is the case with this patient, the lumbar spine is the most common location for this abnormality.
When this diagnosis is made prenatally, cesaerian section is usually recommended, and the birth is planned at a location where a pediatric neurosurgeon and level 3 NICU are available.
At delivery, the defect can be protected with sterile saline-soaked gauze, covered by plastic wrap, and the infant kept in a side-lying or prone position.
Infants with this condition frequently have associated abnormalities; Arnold Chiari malformation, dislocated hips, bowel or bladder dysfunction, and lower extremity weakness are all common co-morbidities.
To keep latex sensitivitiy from becoming a problem, only non-latex gloves and supplies should be used.
photo by Juin Kong, MD