Double myelomeningocele: case report

Abderrazzak, Bertal; Hilmani, S.; Elkamar, A; Elazhari, A.

doi:10.3109/02688697.2011.562989

Cited by 4 publications

(5 citation statements)

References 3 publications

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“…Therefore, the number of centers offering this fetal intervention for selected cases with isolated OSB is growing worldwide [6,7]. Double neural tube defects on the spine are rare, accounting for less than 1% of all defects [8], and are considered a severe condition associated with hydrocephalus often requiring postnatal ventriculoperitoneal shunting, severe motor and neurological impairment, and even infant death [9][10][11][12][13][14][15]. There are only a few cases of double neural tube defects reported in the literature, with a very small proportion of them having been diagnosed prenatally [15,16], and all of them receiving postnatal surgical repair [17][18][19].…”

Section: Discussionmentioning

confidence: 99%

Double Myelomeningocele Repair by Fetal Surgery with a Single Micro-Hysterotomy

Chavelas-Ochoa,

Bermúdez-Rojas,

Medina-Jiménez

et al. 2024

Pediatr Neurosurg

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Introduction: Open spina bifida (OSB) is the most common congenital anomaly of the central nervous system. It is associated with severe neurodevelopmental delay, motor impairment, hydrocephalus, and bowel and bladder dysfunction. In selected cases, intrauterine spina bifida repair has been shown to improve neonatal outcomes. Rarely, the spine can have a double defect compromising two different segments and there is a lack of evidence on the feasibility and benefits of intrauterine repair in these cases. Case Presentation: We present a case with both cervicothoracic and lumbosacral myelomeningocele, Arnold-Chiari malformation type II and bilateral ventriculomegaly, that was treated successfully at 25 weeks with open micro-neurosurgery. Double myelomeningocele was successfully treated through a single 2-cm micro-hysterotomy, by performing external versions to sequentially expose and repair both defects. Weekly postoperative follow-up showed no progression of ventriculomegaly or complications attributable to the procedure. Preterm rupture of membranes prompted a conventional cesarean delivery at 32 weeks of gestation. Neurodevelopmental outcome at 20 months was within normal ranges, having achieved ambulation without orthopedic support and with no need for ventriculoperitoneal shunting. Conclusion: This report demonstrates for the first time the feasibility of double OSB repair through a single 2-cm micro-hysterotomy, suggesting that selected isolated cases of double myelomeningocele could be candidates for fetal intervention. Further prospective studies should be carried out to assess the potential benefit of double OSB intrauterine open repair.

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Section: Discussionmentioning

confidence: 99%

Double Myelomeningocele Repair by Fetal Surgery with a Single Micro-Hysterotomy

Chavelas-Ochoa,

Bermúdez-Rojas,

Medina-Jiménez

et al. 2024

Pediatr Neurosurg

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“…Multiple neural tube defects (MNTD) is an extremely uncommon pathology with a prevalence of < 1% out of 474 cases by Ahmad et al [ 2 ] The neural tube starts approximately the first 4 weeks of the embryogenesis period [ 3 ]. The theory behind the development of neural tube defects (NTD) have been entertained by multiple authors, with the classic “zipper-like” fashion that occurs in the mid-cervical region and then continues cranially and caudally in a bi-directional pathway [ [2] , [3] , [4] ]. However, this theory fails to explain the development of MNTD, as one would expect that most NTDs would occur at the cranial or caudal neuropores rather than halfway in between [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Neural tube defects are common in developing countries with an incidence of 0.4–1.9 per 1000 live births [ 1 , 2 ]. Multiple neural tube defects are extremely uncommon, with few cases reported in the literature.…”

Section: Introductionmentioning

confidence: 99%

Presentation of a double myelomeningocele in the upper thoracic and thoracolumbar spine: A case report

Elarjani

Khairy

Al-Karawi

2020

International Journal of Surgery Case Reports

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“…Potter (1962) described two cases and Bertan (1968) described one case of dorsal and lumbar meningomyelocele. [2] Fahrenkurg and Hojgaard (1963) described a case of multiple paravertebral lumbar meningocele. [3] Tekkok reported a case with three distinct NTDs (a parietooccipital encephalocele, a small cervical MMC, and a thoracolumbar MMC).…”

Section: Discussionmentioning

confidence: 99%

Multiple neural tube defects in a child: A rare developmental anomaly

Singh

Singh²,

Aga³

et al. 2012

Surg Neurol Int

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Background:The presence of multiple neural tube defects (NTDs) is a rare entity. Published literature shows not more than 10 case reports. Such cases contradict the well-established “zipper model” of neural tube closure and support “multi-site closure model.”Case Description:We are reporting a unique case of multiple NTDs in a 5-month-o ld female child. Occipital encephalocele, dorsal meningomyelocele, Split cord malformation (SCM), and tethered cord were present in this case.Conclusion:This case report further substantiate the “multisite closure model,” however, more research work on human neuro-embryology is needed to overcome the controversies of neural tube closure.

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Double myelomeningocele: case report

Cited by 4 publications

References 3 publications

Double Myelomeningocele Repair by Fetal Surgery with a Single Micro-Hysterotomy

Double Myelomeningocele Repair by Fetal Surgery with a Single Micro-Hysterotomy

Presentation of a double myelomeningocele in the upper thoracic and thoracolumbar spine: A case report

Multiple neural tube defects in a child: A rare developmental anomaly

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