Beneficial effects following microsurgical decompression in an adult with congenital thoraco-lumbar kyphoscoliosis with spina bifida aperta and myelomeningocele: an interesting case report

Abstract

Surgery for spinal canal stenosis in patients with severe thoraco-lumbar scoliosis can be effective in relieving radicular pain, weakness and numbness, and while not curative can greatly improve the quality of life.

Micro‐computed tomography assessment of vertebral column defects in retinoic acid‐Induced rat model of myelomeningocele

“…In utero surgical repair offers some improvement of motor function, although the surgical procedures remain inadequate for repairing all developmental malformations in fetuses with MMC, including bone defects (Adzick et al, ; Simpson and Greene, ). Although clinical motor level is an important factor correlating with the occurrence of developmental deformities of the spine in MMC patients, congenital spinal defects such as the deficiency of bone elements in patients with MMC increase their risk for developmental deformities, which may progress with skeletal growth and which can cause problems, including trunk imbalance and neurologic symptoms (Yoshioka et al, ; Ghani and Kroeber, ). Thus, in addition to the soft tissue repair, MMC fetuses could benefit from a treatment approach to repair congenital spinal defects.…”

“…Although the prevalence of spina bifida has declined in the postfortification era with administration of folic acid to pregnant mothers, treatment and management of patients with spina bifida continue to have a huge economic burden on the health care system (Osterhues et al, ). MMC is a devastating birth defect leading to skeletal deformities and significant neurologic injury, including lower extremity paralysis and sensory loss, as well as bowel and bladder incontinence (Hunt, ; Hunt and Poulton, ; Sandler, ; Yoshioka et al, ; Ghani and Kroeber, ). Affected individuals have profoundly diminished quality of life, requiring lifelong support and institutional care.…”

Principles and experience of surgical treatment of spina bifida in adults

“…Источники литературы о spina bifida у взрослых посвящены в основном тем больным, которые были оперированы в детском возрасте, с обсуждением степени их инвалидизации, социальной адаптации, реабилитации и др. [11][12][13][14][15][16]. Обращает на себя внимание высокий уровень инвалидности у взрослых с осложнениями спинномозговых грыж.…”

“…Сообщения о первичном хирургическом вмешательстве по поводу spina bifida у взрослых единичны и не охватывают всего многообразия патологии, носят либо сугубо клинический характер, либо сводятся к сообщениям типа «case report». Отсутствуют четкие прогностические критерии [13]. В этих условиях обобщение и систематизация даже единичных наблюдений этого заболевания у взрослых пациентов, безусловно, будет иметь как теоретическое, так и практическое значение.…”

Quality of life in a 61-year-old paraplegic patient with myelomeningocele: illustrative case

“… 13 While there has been an upward trend in patients with MM living past the age of 40, the number of admissions in patients over age 50 is much smaller. 13 We have found only four other documented reports of patients with MM over the age of 60, detailing (1) a primary repair of an MM in a geriatric patient, 14 (2) the benefits of microsurgical decompression therapy in an adult patient, 15 (3) primary repair of an ulcerated lumbosacral MM in adulthood, 16 and (4) a rare case of an elderly patient with a large prevertebral thoracic MM. 17 In accordance with the literature, our patient is a rare example of an individual with an MM and comorbid hydrocephalus who has survived well into adulthood.…”