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KMID : 0378019710140120057
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New Medical Journal
1971 Volume.14 No. 12 p.57 ~ p.62
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Clinical Observation of the Spina Bifida Cystica
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Abstract
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Among the congenital or developmental anomalies, such as congenital hydrocephalus, spina bifida, cranium bifidum, craniosynostosis and sinus tracts from the skin, etc., spina bifida cystica is the most frequent one.
Spinal bifida is a developmental defect in the spinal axis. The basic embryological error which prod￢uces spina bifida is a segmental failure in the invagination and separation of the neural tube from the epithelial ectoderm, and at the same time, an abnormality in the development of the primitive mesode￢rm, which gives rise surround the neural tissue.
For past 13 years, 41 cases of spinal bifida cystica have been experienced in the Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea, of which 18 cases were meningocele and 23 cases were myelomeningocele. The sex incidence was 27 cases in male and 14 cases in female.
The location of spina bifida cystica was as follows: 16 cases were in lumbar region, 9 cases in lumbosacral, 7 cases in sacral and 5 cases in thoracolumbar.
In these cases, various congenital abnormalities, such as 4 hydrocephalus, 3 foot anomaly, 2 ribanomaly, one skull bone defect and one chest deformity, were associated with the spina bifida cystica.
The surgical treatment was performed in 21 cases of which 9 cases were meningocele and 12 cases were myelomeningocele. None postoperative death or meningitis was encountered but mild wound infection was developed in 6 cases. For progressive hydrocephalus, ventriculo-atrial shunt was performed in two cases before surgical repair of myelomeningocele and obtained good result.
The purposes of operation are to remove the protruding mass, to prevent infection and death, to protect all of the neural elements as much as possible, and not to produce or increase the neurological defect. However, it must be explained in detail to the parents that repair of a myelomeningocele cannot always restore neurological deficit or replace neural tissue.
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