Myelomeningocoele, also known as spina bifida cystica, is a complex congenital spinal anomaly that results in spinal cord malformation (myelodysplasia).
It is one of the commonest congenital CNS anomalies and thought to occur in approximately 1:500 of live births 5. There may be a slight female predilection.
Patients present with a lower limb paralysis and sensory loss, bladder and bowel dysfunction as well as cognitive impairment.
Results from failure of fusion of neural folds dorsally during embryogenesis.
There is a localised defect of the closure of caudal neuropore with persistence of neural placode (open spinal cord).
- lumbosacral: ~45%
- thoracolumbar: ~30%
- lumbar: ~20%
- cervical: ~2%
- in utero folate deficiency
- in utero teratogen exposure
- aneuploidy anomalies
- Chiari II malformation
- arachnoid cysts 1
- tethering of spinal cord
- may show evidence of an open neural tube defect with splayed or divergent posterior elements
- 1- Aaronson OS, Hernanz-schulman M, Bruner JP et-al. Myelomeningocele: prenatal evaluation--comparison between transabdominal US and MR imaging. Radiology. 2003;227 (3): 839-43. doi:10.1148/radiol.2273020535 - Pubmed citation
- 2- Unsinn KM, Geley T, Freund MC et-al. US of the spinal cord in newborns: spectrum of normal findings, variants, congenital anomalies, and acquired diseases. Radiographics. 20 (4): 923-38. Radiographics (full text) - Pubmed citation
- 3- Rufener SL, Ibrahim M, Raybaud CA et-al. Congenital spine and spinal cord malformations--self-assessment module. AJR Am J Roentgenol. 2010;194 (3): S38-40. doi:10.2214/AJR.09.7204 - Pubmed citation
- 4- Lowe LH, Johanek AJ, Moore CW. Sonography of the neonatal spine: part 2, Spinal disorders. AJR Am J Roentgenol. 2007;188 (3): 739-44. doi:10.2214/AJR.05.2160 - Pubmed citation
- 5- Dick EA, Patel K, Owens CM et-al. Spinal ultrasound in infants. Br J Radiol. 2002;75 (892): 384-92. Br J Radiol (full text) - Pubmed citation
Congenital spinal abnormalities
- spinal dysraphism