Spinal dysraphisms are considered congenital anomalies of development of the spine and spinal cord. These conditions occur during development in the womb and are usually recognised at birth. Each type can have different characteristics and may require treatment. Here is more information about some types of spinal dysraphisms and treatment options:
1. Meningocele and meningomyelocele: In these conditions, the contents of the spinal cord and cerebrospinal membrane can be found inside a sac that protrudes outside the body. In meningocele, the sac contains the cerebrospinal membrane and fluid, whereas in meningomyelocele the spinal cord tissue is also in the sac. These types are usually characterised by a swelling or sac impression on the back. Meningomyelocele is a condition in which the spinal cord is affected and therefore often results in paralysis. Treatment is usually surgical closure of the sac and preservation of the spinal cord and cerebrospinal membrane.
2. Dermal Sinus Tract: In this pathology, there is an abnormal pathway or tunnel extending from the skin to the spinal cord. This pathway may require surgical intervention because of the risk of infection.
3. Diastematomyelia (Split Spinal Cord Syndrome): In this condition, the spinal cord is divided into two by bands of bone or soft tissue. This can cause stretching and damage to the spinal cord. Treatment usually involves the removal of these bands.
4. Tethered Cord (Tethered Spinal Cord – Filum Terminale): In this condition, the spinal cord ends at a lower level than normal and is associated with a tissue called the filum terminale. This stretches the spinal cord and can cause paralyses, urinary problems and walking disorders. Treatment may involve surgical cutting of the filum terminale.
Treatment may vary depending on the patient’s condition and the type of spinal dysraphism. Untreated spinal dysraphisms can lead to neurological problems and risk of infection, so early diagnosis and treatment is important. After treatment, patients are followed up regularly and possible complications are monitored. In addition, other health problems related to these conditions should be assessed, for example urinary and kidney problems are frequently observed. Therefore, follow-up by paediatric nephrology and/or paediatric urology doctors may also be needed.