Meningocele lumbar spine and sacrum (s2) – causes and treatment
Meningocele (spina bifida) is one of the congenital malformations of the spine and spinal cord. It is based on incomplete closure of the neural tube – the anatomical structures of the embryonic period.
There are three types of malformations associated with spina bifida (Latin: spinabifida): spina bifida occulta, meningocele and meningomyelocele. They are manifestations of the same pathological process, with different degrees of severity.
Spina bifida occulta (hidden spina) is an exclusively bone defect is a crack in the rear wall of the vertebra or several vertebrae. This happens most often in the lumbar or lumbosacral spine from L1 (first lumbar vertebra) to S2, S3 (second and third sacral). Neither of the membranes of the spinal cord or the spinal nerve roots through the defect of the bone does not protrude.
On the back of a newborn may not have any signs of illness. In many cases people do not suspect about the presence of this malformation of the spine and learns about it by chance during radiological examinations.
Meningocele is a more severe pathology. Through a bony defect in the posterior portion of the vertebra meninges protrude under the skin, forming a pocket. This pocket is filled with cerebrospinal fluid, turning into a cyst. Cysts can be of different sizes: from small to giant.
However, the substance of the spinal cord and the spinal nerve roots do not get into the bone defect and not infringed there. This means that if a meningocele severe neurologic disorders usually do not occur and surgical treatment is very effective.
The most difficult and Most frequent of the variants of spina bifida – meningomyelocele. With this developmental defect in the bone is protruding outwards all the contents of the spinal canal (the spinal cord with its membranes and nerve roots). It can cause severe neurological problems.
In the development of all types of spina bifida heredity plays a role. This confirms the fact that the frequency of birth of children with spinabifida have parents who themselves suffer from this defect, higher than in the population.
risk Factors for the development of the disease in children are intrauterine infection, ionizing irradiation, the temperature rise of the body of the mother, the action of chemical toxins (e.g. Pesticides), receiving anticonvulsants (anticonvulsants) during pregnancy, lack in the diet of pregnant folic acid.
The most important period is the first weeks of pregnancy when the neural tube is formed. Normally it should close during the fourth week of gestation.
the Main symptom of this disease is the presence of a hernia SAC. On the back, most often in the lumbosacral region from L1 to S2, S3, is defined subcutaneous soft tissue protrusion. In most cases, any discomfort it causes.
Sometimes spinal membranes in place of the protrusions can be covered with skin. In this case surgical treatment is needed urgently to close the "gate" for infection.
Meningocele in the lumbar spine called lumbar. Another name for sacral meningocele sacral meningocele.
A Primary medical examination allows to suspect the presence of a newborn child of this disease. The method of choice for diagnosis is magnetic resonance imaging (MRI). MRI allows you to determine exactly what is the content of the hernia SAC.
Computed tomography of the spine in the division of L1 – S2, S3 can also determine the nature of the defect, but its use is limited in the neonatal period due to radiation exposure.
Ultrasound is used in pregnancy for screening of malformations of the neural tube.
Treatment and prevention
Meningocele in region of L1 – S2, S3 has a good prognosis for surgical cure. Since the hernia SAC in meningocele not involved the spinal cord tissue, after surgical treatment, the person may fully recover.
Conservative (non-surgical) methods of treatment of this disease does not exist. Operation in addition to addressing the cosmetic defect aims at closing the entrance gate for the possible penetration of infection inside the spinal canal.
Currently actively developed methods of antenatal surgical correction of the defect, i.e., operations on the spinal column of the fetus when it is still in the womb.
The First area of prevention – in pregnancy you should avoid risk factors for spinabifida. Active prevention is the medication folic acid during pregnancy.