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Urology 2020 May 10. Epub 2020 May 10.

Pediatric Urology and Regenerative Medicine Research Center, Children's Medical Center, Pediatric Center Excellence, Tehran University of Medical Sciences, Tehran, Iran (IRI). Electronic address:

Objectives: To compare the outcomes of intravesical injection of botulinum toxin A (BoNTA) with intravesical electromotive drug administration (EMDA) of BoNTA on urinary incontinence secondary to neuropathic detrusor overactivity (NDO) in children with myelomeningocele (MMC).

Materials And Methods: A total of 26 children with MMC (11 boys, 15 girls) who had urinary incontinence secondary to NDO were retrospectively enrolled in the study. Patients in EMDA group (n=14), using an electrode-catheter, 10 IU/kg of BoNTA were inserted into the bladder for EMDA without anesthesia and on an outpatient basis. Read More

Trends Neurosci 2020 May 15. Epub 2020 May 15.

Department of Neurosciences, University of California, San Diego, La Jolla, CA 92093, USA; Rady Children's Institute for Genomic Medicine, Rady Children's Hospital, San Diego, CA 92025, USA. Electronic address:

Neural tube defects (NTDs) represent a failure of the neural plate to complete the developmental transition to a neural tube. NTDs are the most common birth anomaly of the CNS. Following mandatory folic acid fortification of dietary grains, a dramatic reduction in the incidence of NTDs was observed in areas where the policy was implemented, yet the genetic drivers of NTDs in humans, and the mechanisms by which folic acid prevents disease, remain disputed. Read More

Int J Surg Case Rep 2020 May 11;70:137-139. Epub 2020 May 11.

Department of Digestive Surgery, Centre Hospitalier de Saint-Denis, 2 rue du Docteur Delafontaine, 93200 Saint-Denis, France. Electronic address:

Introduction: Bariatric surgery has been increasingly popular during the last years because of its proven efficacy on obesity and related complications. However, nutrient deficiency is common after surgery, in particular after Roux-en-Y gastric bypass (RYGB) or omega gastric bypass (OGB), due to iatrogenic malabsorption. All vitamins and minerals could be involved, including vitamin B9 which plays an important role in the prevention of neural tube defects during pregnancy. Read More

BJOG 2020 May 14. Epub 2020 May 14.

Department of Obstetrics and Gynecology, Texas Children's Hospital & Baylor College of Medicine, Houston, Texas, USA.

Objectives: (1) To compare brain findings between large and non-large neural tube defect (NTD); (2) To evaluate the impact of large lesion on the surgical parameters; (3) To study any associations between the size of the lesions and brain findings six weeks postoperatively, and neurological short-term outcomes.

Design: Retrospective cohort study SETTING: Texas Children's Hospital, between 2011 and 2018 POPULATION: Patients who underwent prenatal NTD repair METHODS: Large lesion was defined when the lesion's surface was greater than the 75 percentile of our cohorts' lesions.

Main Outcome Measures: Time of referral: ventriculomegaly and anatomical level of the lesion; Surgery: duration and need for relaxing incisions; Six post-operative weeks: hindbrain herniation (HBH) and ventriculomegaly; After delivery: dehiscence, need for hydrocephalus treatment and motor function. Read More

J Neurosurg Pediatr 2020 May 8:1-2. Epub 2020 May 8.

2The Hospital for Sick Children, Toronto, ON, Canada.

Cureus 2020 Apr 1;12(4):e7502. Epub 2020 Apr 1.

Obstetrics and Gynaecology, Maulana Azad Medical College, New Delhi, IND.

Lethal congenital malformations (LCMs) are fatal birth defects that are an important cause of fetal/neonatal death. There is a lack of informative data about these malformations in India, a country that shares the maximum burden of neonatal mortality due to congenital birth defects. Therefore, we conducted a retrospective analysis to know the prevalence of LCMs in late pregnancy, to find out associated factor/variables and to evaluate fetal/neonatal outcome of such anomalies; at a tertiary-care referral centre in North India. Read More

Urology 2020 Apr 30. Epub 2020 Apr 30.

Division of Urology, Nationwide Children's Hospital, Columbus, OH.

Objective: To understand the utilization of augmentation cystoplasty (AC) for the management of neurogenic bladder in children with myelomeningocele (MMC). AC carries considerable risk. To mitigate this, recent studies have emphasized alternatives to AC, but it is unknown if these interventions have resulted in fewer ACs being performed. Read More

Am J Case Rep 2020 Apr 30;21:e922312. Epub 2020 Apr 30.

Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.

BACKGROUND Incomplete closure of the neural tube results in congenital anomalies called neural tube defects (NTD). These defects are rarely multiple, and are characterized by loss of central nervous system soft tissue and bony coverings, along with herniation of the involved part of the CNS through the defect. CASE REPORT A newborn female infant was delivered through planned cesarean section due to large occipital encephalocele diagnosed antenatally. Read More

Ann Plast Surg 2020 Apr 27. Epub 2020 Apr 27.

From the Section of Plastic Surgery.

Background: Repair of the soft tissue defect in myelomeningoceles remains challenging. The literature currently lacks a systematic approach, reporting high rates of complications. We present outcomes from the largest series to date and describe a simplified approach that minimizes morbidity and streamlines decision making. Read More

Folia Med (Plovdiv) 2019 09;61(3):462-466

Medical University, Plovdiv, Bulgaria.

Myelomeningocele is a common defect of the development of the neural tube. It is a complex congenital malformation of the central nervous system (CNS) that can be associated with other concurrent anomalies. We report on a case of lumbar myelomeningocele with concomitant CNS malformations we followed up over a period of 15 years. Read More

Neurol Genet 2020 Jun 1;6(3):e414. Epub 2020 Apr 1.

National Institutes of Health (J.S.R., A.J.C., H.W., Z.Z.), National Cancer Institute Neuro-Oncology Branch; National Institutes of Health (D.P.A., J.D.H.), National Institute of Neurological Disorders and Stroke, Surgical Neurology Branch; National Institutes of Health (Y.P., A.J., K.P.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Section on Medical Neuroendocrinology; Georgetown Hospital (M.A.N.), Internal Medicine and Pediatrics, Washington DC; National Institutes of Health (J.P.M., D.R.D.), National Institute of Neurological Disorders and Stroke, Mouse Imaging Facility, Bethesda, MD; George Washington University (J.G.S.), Radiology, Washington DC; National Library of Medicine (J.G.S.), MedPix®; National Institutes of Health (M.M.M.), Center for Cancer Research, National Cancer Institute, Laboratory of Pathology; and National Institutes of Health (R.H.K., B.A.K.), National Heart Lung and Blood Institute, Translational Vascular Medicine Branch, Bethesda, MD.

Objective: To investigate the effect of somatic, postzygotic, gain-of-function mutation of Endothelial Per-Arnt-Sim (PAS) domain protein 1 () encoding hypoxia-inducible factor-2α (HIF-2α) on posterior fossa development and spinal dysraphism in gain-of-function syndrome, which consists of multiple paragangliomas, somatostatinoma, and polycythemia.

Methods: Patients referred to our institution for evaluation of new, recurrent, and/or metastatic paragangliomas/pheochromocytoma were confirmed for gain-of-function syndrome by identification of the gain-of-function mutation in resected tumors and/or circulating leukocytes. The posterior fossa, its contents, and the spine were evaluated retrospectively on available MRI and CT images of the head and neck performed for tumor staging and restaging. Read More

J Korean Neurosurg Soc 2020 May 27;63(3):346-357. Epub 2020 Apr 27.

Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul, Korea.

During the follow-up period after surgery for spinal dysraphism, a certain portion of patients show neurological deterioration and its secondary phenomena, such as motor, sensory or sphincter changes, foot and spinal deformities, pain, and spasticity. These clinical manifestations are caused by tethering effects on the neural structures at the site of previous operation. The widespread recognition of retethering drew the attention of medical professionals of various specialties because of its incidence, which is not low when surveillance is adequate, and its progressive nature. Read More

J Korean Neurosurg Soc 2020 May 27;63(3):342-345. Epub 2020 Apr 27.

Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul, Korea.

Some types of spinal dysraphism can be accompanied by extraspinal cysts, including myelomeningocele, myelocystocele, myelocele, meningocele, limited dorsal myeloschisis, lipomyelomeningocele, and terminal myelocystocele. Each disease is classified according to the developmental mechanism, embryologic process, site of occurrence, or internal structure of the extraspinal cyst. In most cystic spinal dysraphisms except meningocele, part of the spinal cord is attached to the cyst dome. Read More

Ultraschall Med 2020 Apr 24. Epub 2020 Apr 24.

University Hospital Zurich, The Zurich Center for Fetal Diagnosis and Therapy, Zurich, Switzerland.

Purpose:  The aim was to describe the sonographic follow-up of hindbrain herniation (HH), the banana and lemon sign after fetal myelomeningocele (fMMC) repair, and the time of disappearance of these signs after the intervention, and to investigate any predictive value for the necessity of shunting during the infant's first year of life. Additionally, the sonographic evolution of the transcerebellar diameter (TCD) before and after fetal intervention was assessed.

Patients And Methods:  The first 50 patients that underwent fMMC repair at Zurich Center for Fetal Diagnosis and Therapy (www. Read More

Childs Nerv Syst 2020 Apr 23. Epub 2020 Apr 23.

Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Background: Spinal dysraphic anomalies may be hidden beneath grotesque cutaneous stigmata, like a fully developed accessory lower limb.

Case Description: Authors describe a 4-year-old boy who had socially unacceptable malformation in form of an accessory lower limb, in addition to perfectly normal both lower limbs with underlying low-lying tethered cord. Radiological studies showed underlying tethered cord and dysraphic spinal column. Read More

Curr Opin Anaesthesiol 2020 Jun;33(3):368-373

Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia.

Purpose Of Review: This review describes maternal and fetal anesthetic management for noncardiac fetal surgical procedures, including the management of lower urinary tract obstruction, congenital diaphragmatic hernia (CDH), myelomeningocele, sacrococcygeal teratoma, prenatally anticipated difficult airway and congenital lung lesions.

Recent Findings: Fetal interventions range from minimally invasive fetoscopic procedures to mid-gestation open surgery, to ex-utero intrapartum treatment procedure. Anesthetic management depends on the fetal intervention and patient characteristics. Read More

J Pediatr Adolesc Gynecol 2020 Apr 15. Epub 2020 Apr 15.

Division of Neonatology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Background: Neural tube defects are a group of congenital malformations in which the spinal column is bifid as a result of failed closure of the embryonic neural tube. Although not common, they might be complicated with pelvic organ prolapse mostly due to abnormal innervation and the resulting atrophy of the pelvic floor musculature.

Case: In this case report we present a newborn with uterovaginal prolapse in the setting of meningomyelocele, in whom the prolapse of pelvic organs spontaneously ameliorated after surgical correction of meningomyelocele. Read More

Br J Neurosurg 2020 Apr 17:1-4. Epub 2020 Apr 17.

Umraniye Education and Research Hospital Department of Orthopeadics and Traumatology, University of Health Sciences, Umraniye, Turkey.

We report a new surgical incision for spinal deformity in patients who had undergone meningomyelocele closure surgery. Six patients underwent kifectomy using an inverse Y incision. They all had multiple prior operations in the lumbar region due to dural meningomyeloceles. Read More

J Matern Fetal Neonatal Med 2020 Apr 15:1-9. Epub 2020 Apr 15.

Department of Pathology, Escola Paulista de Medicina - Federal University of São Paulo, São Paulo, Brazil.

To characterize aspects of the repair process by evaluating the tissue collagen density, metalloproteinases and tissue inhibitor of matrix metalloproteinases in the fetal membranes following open fetal surgery for myelomeningocele (MMC). Experimental. Two Brazilian hospitals in 2013-2014. Read More

Pak J Med Sci 2020 Mar-Apr;36(3):422-425

Dr. Raza Rizvi, MS. Department of Neurosurgery, Jinnah Postgraduate Medical Center, Karachi, Pakistan.

Objective: To determine the risk factors, presentation and outcome of meningomyelocele repair.

Methods: We reviewed 150 cases operated for meningomyelocele (MMC) at Jinnah Postgraduate Medical Centre Karachi between May 2015 and May 2018. Data of infants operated for MMC repair was extracted including socioeconomic status, maternal folate intake during pregnancy, head circumference, location and width of the defect, accompanying bladder and limb anomalies and treatments administered. Read More

Am J Obstet Gynecol 2020 Apr 10. Epub 2020 Apr 10.

Department of Obstetrics and Maternal-Fetal Medicine, Necker-Enfants Malades Hospital, AP-HP and Paris Descartes University; EHU FETUS, Université de Paris and IMAGINE Institute. Electronic address:

Background: Despite undisputable benefits, midtrimester prenatal surgery is not a cure for myelomeningocele (MMC): residual intracranial and motor deficits leading to lifelong handicap question the timing of prenatal surgery. Indeed, the timing and intensity of intrauterine spinal cord injury remains ill defined.

Objective: We aimed to describe the natural history of neuronal loss in MMC in utero based on postmortem pathology. Read More

Ginekol Pol 2020 ;91(3):123-131

Medical University of Silesia, Gynecology Clinical Care Unit, Obstetrics and Oncological Gynecology, Bytom, Poland.

Objectives: We aimed to show how increased experience of a surgery team in fMMC repair influences maternal and fetal/neonatal outcomes.

Material And Methods: We compare perinatal results of fMMC repair in our Fetal Surgery Center (FSC) in cohort groups for the early period (2005-2011 year; previous - PFSC, n = 46) and current period (2012-2015 year; current - CFSC, n = 74) to results of the randomized Management of Myelomeningocele Study (MOMS, 78 patients).

Results: The maternal morbidity due to fMMC repair was low and there was no difference comparing CFSC to PFSC and MOMS. Read More

Surg Neurol Int 2020 13;11:45. Epub 2020 Mar 13.

Department of Anesthesia, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Background: Meningoceles are congenital herniation of meninges and cerebrospinal fluid (CSF) through the skull and are bereft of any cerebral tissue. They are commonly found over the anterior fontanelle. Although some cases of cervical dysraphism have been described in the literature, a true meningocele has rarely been seen. Read More

Disabil Rehabil 2020 Apr 7:1-5. Epub 2020 Apr 7.

Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, CA, USA.

To examine associations between neurosegmental and functional level classifications in children with Spina Bifida, and determine which classification best reflects daily walking activity. A prospective correlational study was conducted. Children with Spina Bifida were given ratings for lesion level [X-ray and International Myelodysplasia Study Group (IMSG) level determined by muscle strength] and functional level [Hoffer ambulatory level and Dias functional classification of myelomeningocele (FCM), Functional Mobility Scale (FMS)]. Read More

Childs Nerv Syst 2020 Apr 4. Epub 2020 Apr 4.

Pediatric Neurosurgery at Vila da Serra Hospital, Alameda Oscar Niemeyer, 499, Vila da Serra, Nova Lima, Brazil.

Purpose: Myelomeningocele (MMC) is the most frequent form of spina bifida. Moreover, 90% of patients with MMC have hydrocephalus and require shunt placement. However, shunt failure management in such patients typically involves several shunt revisions, increasing the risk for morbidity and mortality. Read More

Mayo Clin Proc 2020 Apr;95(4):738-746

Center for Regenerative Medicine, Mayo Clinic College of Medicine, Rochester, MN; Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN.

Objective: To assess our initial experience with prenatal restoration of hindbrain herniation following in utero repair of myelomeningocele (MMC).

Patients And Methods: Three consecutive patients with prenatally diagnosed MMC (between January 1, 2018 and September 30, 2018) were managed with open in utero surgery. As per institutional review board approval and following a protocol designed at the Mayo Clinic Maternal & Fetal Center, fetal intervention was offered between 19 0/7 and 25 6/7 weeks of gestation. Read More

Turk Neurosurg 2020 ;30(3):449-453

Baskent University Istanbul Health Research and Application Center, Department of Neurosurgery, Istanbul, Turkey.

Aim: To investigate the relationship between the distribution of ABO or Rhesus (Rh) blood group antigens and the incidence of myelomeningocele.

Material And Methods: A retrospective data was reviewed for all myelomeningocele patients operated at a tertiary academic hospital between years 2014 and 2019. Age, sex, delivery method, physical and neurological examination findings, and radiological findings alongside with blood type of each patient were recorded. Read More

Childs Nerv Syst 2020 Apr 1. Epub 2020 Apr 1.

Department of Neurosurgery, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil.

Purpose: The aim of this study was to analyze the skull base anatomy of patients who underwent intrauterine or postnatal myelomeningocele repair and to determine its relationship with hydrocephalus.

Methods: This was a retrospective cross-sectional study that analyzed three groups: the postnatal group, 57 patients who underwent myelomeningocele repair up to 48 h after birth; the fetal group, 70 patients who underwent myelomeningocele repair between 19 and 27 weeks of gestation; and a control group (65). We compared the rate of hydrocephalus treatment, the clivus-supraocciput angle (CSA), and the Welcher angle. Read More

J Spinal Cord Med 2020 Mar 30:1-6. Epub 2020 Mar 30.

Clinical Department of Children's Surgery, Department of Children's Surgery and Urology, School of Medicine in Katowice, Medical University of Silesia in Katowice, Katowice, Poland.

Chemical and mechanical injury in myelomeningocele (MMC) during the fetal life results in functional disorders of multiple organs. Prenatal MMC repair reduces sequelae of spinal cord injury. Histopathological evaluation of dura mater and skin specimens to assess the severity of inflammatory changes. Read More

Childs Nerv Syst 2020 Mar 27. Epub 2020 Mar 27.

Faculty of Medicine, Department of Anesthesiology and Reanimation, Sutcu Imam University, Kahramanmaras, Turkey.

Intraoperative neuromonitoring has become an increasingly commonly applied practice during surgical operations for preventing formation of neurological damage. Although it has been used on adults for a long time, the benefits and techniques of applying it in small children are not clear. We applied two different anesthesia protocols during meningomyelocele repair alongside motor-evoked potentials in a newborn and a small infant. Read More

Pediatr Int 2020 Apr 24;62(4):496-497. Epub 2020 Mar 24.

Department of Neonatology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.

Am J Phys Med Rehabil 2020 Feb 20. Epub 2020 Feb 20.

Veterans Affairs Pittsburgh Healthcare System, Human Engineering Research Laboratories, Pittsburgh, PA.

Objective: Evidence is limited regarding clinical factors associated with ambulation status over the lifespan of individuals with myelomeningocele (MMC). We used longitudinal data from the National Spina Bifida Patient Registry to model population-level variation in ambulation over time and hypothesized that effects of clinical factors associated with ambulation would vary by age and motor level.

Design: A population-averaged generalized estimating equation was used to estimate the probability of independent ambulation. Read More

Obstet Gynecol Sci 2020 Mar 18;63(2):108-116. Epub 2020 Feb 18.

Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan.

With recent advances in fetal medicine, various attempts have been made to save fetuses facing perinatal death or devastating consequences despite optimal management after birth. The concept of the fetus as a patient has been established through the application of treatments. This paper reviews fetal therapies in order to highlight the role of perinatal medicine as standard prenatal care. Read More

J Surg Res 2020 Jul 17;251:262-274. Epub 2020 Mar 17.

Department of Bioengineering, University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado. Electronic address:

Background: Myelomeningocele (MMC) is an open neural tube defect of the spinal column. Our laboratory previously introduced a reverse thermal gel (RTG) as the first in situ forming patch for in utero MMC application. To overcome the challenges of anchoring the RTG in the wet amniotic environment to improve MMC coverage, we modified the RTG to mimic the underwater adhesive properties of mussels. Read More

Pediatr Infect Dis J 2020 Mar 18. Epub 2020 Mar 18.

Division of Infectious Disease Department of Medicine.

A female infant underwent myelomeningocele repair and developed persistent ventricular dilatation. Cerebrospinal fluid (CSF) indices demonstrated meningitis with cultures growing Mycoplasma hominis. The infant was treated with multiple antibiotics including moxifloxacin. Read More

Childs Nerv Syst 2020 Mar 14. Epub 2020 Mar 14.

Department of Pediatric Surgery, King George's Medical University, Lucknow, 226003, India.

Tourniquet syndrome is a rare condition where a tourniquet applied to an appendage leads to an obstructed blood flow and subsequent ischemic injury. Meningomyelocele and meningocele are common birth defects, and involvement of meningocele in tourniquet syndrome is never mentioned in the literature. We managed a 10-day-old male child presenting with infected lumber meningocele with a tourniquet tied at its base. Read More

JPRAS Open 2019 Sep 13;21:75-85. Epub 2019 Jul 13.

Department of Burns, Plastic & Reconstructive Surgery, PGIMER & Dr. R.M.L Hospital, New Delhi 110001, India.

Background: The estimated incidence of spina bifida is 1-2 cases per 1000 population. In earlier literature, the global prevalence of meningomyelocele (MMC) is reported as 0.8-1. Read More

Neurocirugia (Astur) 2020 Mar 7. Epub 2020 Mar 7.

Cátedra de Neurociencias, Universidad Cardenal Herrera CEU-Fundación Vithas Nisa, Moncada, Valencia, España; Servicio de Neurocirugía, Hospital Universitario de La Ribera, Alzira, Valencia, España.

Introduction: Child hydrocephalus in low- and middle-income countries represents one of the most sensitive ethical and health problems facing international health development. The most optimistic estimates indicate that 200,000 newborns annually will develop hydrocephalus or be born with a neural tube defect in East, Central and South Africa (ECSA). It is estimated that less than 10% of these children will be operated by ventriculoperitoneal shunts, and in general in poor quality conditions or with a very high complication rate. Read More

Turk Neurosurg 2020 ;30(2):194-198

Department of Neurosurgery, Ankara University School of Medicine, Ankara,Turkey.

Aim: To define the optimal time of shunt insertion in patients with neural tube defects and hydrocephalus.

Material And Methods: In total, 71 patients who underwent operation for neural tube defects and hydrocephalus were retrospectively evaluated between 2012 and 2018. The first group comprised 43 patients who underwent operation at different times (in 10 days after the repair of defect), and the second group comprised 28 patients who underwent operation at the same time. Read More

Childs Nerv Syst 2020 Mar 9. Epub 2020 Mar 9.

Sheffield Children's Hospital, Sheffield, UK.

Introduction: Ventriculoperitoneal shunt insertion during the neonatal period and early infancy is associated with a high rate of shunt failure when compared to the adult population. Furthermore, the function of flow-regulated valves and differential pressure valves may be different in neonatal hydrocephalus.

Methods: A retrospective case series of all primary shunt procedures carried out during or immediately following the neonatal period, from August 2011 to February 2018 at Sheffield Children's Hospital. Read More

Phys Occup Ther Pediatr 2020 Mar 6:1-13. Epub 2020 Mar 6.

Doctor of Physical Therapy Program, University of St. Augustine for Health Sciences, Austin, Texas, USA.

We investigated relationships among the Pediatric Neuromuscular Recovery Scale (Peds NRS), modified Hoffer Scale, and spatiotemporal gait parameters in children with myelomeningocele (MMC). 21 children with MMC, age 5.3 years (SD = 2. Read More

J Pediatr Urol 2019 Dec 20. Epub 2019 Dec 20.

Department of Surgery, Division of Pediatric Urology, The Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA; Department of Surgery, Division of Urology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, 19104, USA. Electronic address:

Introduction: Early proactive treatment of patients with high-risk neurogenic bladder from spina bifida (SB) may preserve renal function and decrease the need for bladder augmentation later in life. Timing of initiation of anticholinergic therapy (AC) medication and clean intermittent catheterization (CIC) is variable and based on imprecise studies. The authors hypothesized that initiation of AC after the initial video-urodynamic study (VUDS) may benefit bladder capacity even in children who do not meet the standard hostile criteria for starting AC. Read More

Neurosurg Focus 2020 03;48(3):E14

2Developmental Pediatrics, Department of Pediatrics, Baylor College of Medicine, Houston, Texas.

Objective: The recognition that neurosurgeons harbor great potential to advocate for the care of individuals with neural tube defects (NTDs) globally has sounded as a clear call to action; however, neurosurgical care and training in low- and middle-income countries (LMICs) present unique challenges that must be considered. The objective of this study was to systematically review publications that describe the challenges and benefits of participating in neurosurgery-related training programs in LMICs in the service of individuals with NTDs.

Methods: Using MEDLINE (PubMed), the authors conducted a systematic review of English- and Spanish-language articles published from 1974 to 2019 that describe the experiences of in-country neurosurgery-related training programs in LMICs. Read More

BJOG 2020 Feb 29. Epub 2020 Feb 29.

Service de Médecine Foetale, Centre de Référence Maladie Rares MAVEM, Hôpital Armand Trousseau, Médecine Sorbonne Université, APHP, Paris, France.

Objective: To investigate cerebral anomalies other than Chiari type 2 malformation in fetuses with myelomeningocele (MMC).

Design: A retrospective cohort study in a single tertiary centre.

Setting: A review of associated cerebral anomalies in cases with prenatal diagnosis of myelomeningocele. Read More

J Neurosurg Pediatr 2020 Feb 28:1-8. Epub 2020 Feb 28.

1Division of Pediatric Neurosurgery.

Objective: The Management of Myelomeningocele Study demonstrated that fetal surgery, as compared to postnatal repair, decreases the rate of hydrocephalus and improves expected motor function. However, fetal surgery is associated with significant maternal and neonatal risks including uterine wall dehiscence, prematurity, and fetal or neonatal death. The goal of this study was to provide information about counseling expectant mothers regarding myelomeningocele in the era of fetal surgery. Read More

World Neurosurg 2020 May 26;137:376-378. Epub 2020 Feb 26.

University of South Florida Morsani College of Medicine, Department of Neurosurgery, Tampa General Hospital, Tampa, Florida, USA. Electronic address:

Background: Cervical myelomeningocele (MMC) is a very rare neural type defect that is usually discovered and managed in childhood. It is best described as a closed type of spinal dysraphism, where the posterior portion of the cervical thecal sac forms a pouch that bulges out through a narrow posterior spina bifida and contains spinal neural tissue with or without cerebrospinal fluid.

Case Description: We report a 47-year-old male patient who presented with neck pain and decreased ability to use his fingers that had progressed over 3 years before presentation. Read More

Fetal Diagn Ther 2020 Feb 25:1-7. Epub 2020 Feb 25.

Department of Surgery, University of California-Davis, Sacramento, California, USA.

Introduction: The ovine model is the gold standard large animal model of myelomeningocele (MMC); however, it has a high rate of fetal loss. We reviewed our experience with the model to determine risk factors for fetal loss.

Methods: We performed a retrospective review from 2009 to 2018 to identify operative factors associated with fetal loss (early fetal demise, abortion, or stillbirth). Read More

Fetal Pediatr Pathol 2020 Feb 25:1-5. Epub 2020 Feb 25.

Fetopathology Unit, Hospital Habib Bougatfa of Bizerte, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.

Luckenschadel is commonly associated with Chiari II malformation and myelomeningocele. The aim of this case report was to revisit this entity. Antenatal imaging performed at 32 weeks gestation showed severe hydrocephalus with brain parenchymal thinning, cerebellar hypoplasia and lumbar myelomeningocele, suggestive of Chiari type II malformation. Read More

Plast Reconstr Surg Glob Open 2020 Jan 20;8(1):e2539. Epub 2020 Jan 20.

Department of Neurosurgery, University Hospital of North Norway, Tromsø, Norway.

This article describes the triple use of autologous amnion graft as a new procedure in the treatment of myelomeningocele and in myelomeningocele with split cord malformation. The first amnion graft was used as a physical and mechanical barrier to protect the myelomeningocele (MMC) from desiccation and mechanical stress directly after birth. A second graft was used as a dura substitute to close the cerebrospinal fluid compartment. Read More