Spina Bifida. Management and Outcome

About this book

The evolution of technology has made new surgical techniques available for the treatment of diseases associated with the Spina Bifida malformation, and this is especially true in hydrocephalus and fetal surgery. The progress in this last field and in prenatal diagnosis have raised the significant problem of the effectiveness and usefulness of in utero surgical treatment of the malformation, that are extensively discussed in this volume. Also the clinical situations that can be seen in adolescents or young adults with spina bifida, including sexuality and pregnancy, are highlighted.

Aim of this book to promote a multidisciplinary approach to spina bifida, providing the three main specialists categories involved - neurosurgeon, orthopaedic surgeons, and urologists - with a concise reference that explains the main clinical problems to be faced in everyday clinical practice and with an updated overview of surgical approaches.

Written for:

Neurosurgeons, orthopaedic surgeons, urologists, neurologists

Keywords:

• Chiari malformation
• Hydrocephalus
• Myelomeningocele
• Spina Bifida

Table of contents

Introduction.- History of myelomemingocele.- Embryology.- Epidemiology and etiologic factors.- Ethics and medico-legal issues.- Prevention of open spinal dysraphism.- Prenatal diagnosis of spina bifida.- Initial management of spina bifida baby (clinical presentation, neurological evaluation, to the OR).- Radiological evaluation of spina bifida (including cranial malformations).- Primary repair – surgical technique.- Anesthesiology of the newborn with spina bifida.- Postoperative care in NICU.- Early surgical complications of open spinal dysraphism.- Spinal malformations and vertebral anomalies in spina bifida.- Plastic surgical aspects of large open myelomeningocele.- Chiari ii malformation & syringomyelia.- Hydrocephalus: pathophysiology.- The treatment of hydrocephalus in spina bifida - shunts.- The treatment of hydrocephalus in spina bifida - endoscopy.- Additional cranial malformations in spina bifida (excluded chiari).- The role of fetal neurosurgery in spina bifida .- Secondary tethered cord syndrome in spina bifida.- Spasticity in spina bifida.- Orthopedic problems: Management of vertebral problems and deformities. Management of hip, knee and foot problems in spina bifida. Rehabilitation of children with open spinal dysraphism. Ortheses and supportive devices for walking. Motion analysis.- Urology: Urology. Sexuality, sex, pregnancy, and spina bifida. Intellectual outcome.