A meningocele is a type of spina bifida. Spina bifida meningocele occurs when a baby’s spine does not develop normally during pregnancy. There is a hole in the baby’s spine upon birth.
A sac called a meningocele pushes through the opening in the spine. Usually, a thin layer of skin covers it. The sac consists of the membranes covering the brain and spinal cord, called the meninges, and the spinal fluid. The spinal cord is in the spinal canal where it should be.
The infant may have a meningocele on their back, neck, or head. Most babies with meningoceles lead normal, healthy lives after surgery to correct the condition.
Types According To Severity
Spina bifida occulta: only gap in bony bridge without any protruding layers.
Meningocele: Only the meninges (the covering of the brain/spinal cord) + CSF come out in a sac. The spinal cord and nerves stay inside. Very mild, no neurological symptoms.
Meningomyelocel: Meninges + Spinal cord + Nerves all come out in the sac. Moderate to severe one
Myelocel: The spinal cord is open and exposed with no covering. Most severe one.
In this blog, we will discuss only myelocele.
What are the Types of Meningocele?
Cervical Meningocele
One of the rarest types is cervical meningocele, which affects the neck area of the spine. If left untreated, it may manifest as a soft swelling that affects surrounding nerves. Often, early surgical intervention produces positive results.
Thoracic Meningocele
This kind appears in the centre or upper back. Depending on the size and location of the sac, some children may have nerve-related problems, while others may have few symptoms. Timely meningocele treatment and routine monitoring are crucial.
Lumbar Meningocele
One of the more prevalent kinds is lumbar meningocele, which develops in the lower back. Surgery is usually advised to avoid complications and safeguard the spinal structures, even though the majority of cases involve little to no nerve injury.
Sacral Meningocele
Sacral meningocele develops near the base of the spine. Usually, it presents as noticeable swelling over the buttocks or lower back. Most children can have favourable long-term results with early diagnosis and proper surgical care.
What Causes Meningocele?
The first month of pregnancy is when all forms of spina bifida occur. The spinal cord of a fetus is initially flat. After that, it closes into a neural tube.
A baby with spina bifida is born if this tube does not completely seal. In meningocele, a sac that holds the meninges and spinal fluid pushes through the opening in the spine. The cause of some babies’ meningocele is unknown.
Inadequate folic acid intake during the early stages of pregnancy & inadequate body stock of folic acid before pregnancy can result in the disease. Other causes are
- used certain seizure medications while pregnant
- had already given birth to a child with spina bifida
- had diabetes
Signs and Symptoms of Meningocele
The majority of infants with meningoceles show no symptoms. Unlike spina bifida occulta, which is a mild form of spina bifida that often goes unnoticed, meningocele presents as a visible sac protruding through the spine. In some cases, the nerves around the spine can sustain damage, although this is rare. This may result in several health problems, including difficulty moving and controlling the flow of urine.
Diagnosis of Meningocele
During pregnancy, a blood test known as alpha-fetoprotein (AFP) can determine whether a baby is at risk for meningocele. A fetal MRI or prenatal ultrasound can reveal if a baby has one. When a baby is born, a meningocele that was not identified during pregnancy is discovered.
Potential Issues Following a Meningocele Diagnosis
Compression of a meningocele, a kind of spinal deformity, can cause symptoms of elevated intracranial pressure. The reason for this is that the compression forces additional spinal fluid into the skull. The base of the skull may wear away due to high pressure inside the skull, resulting in brain and spinal fluid leakage.
Tethered cord syndrome frequently coexists with meningocele. Tethered cord syndrome symptoms have been observed in many children who have had meningocele corrected. Myelomeningocele, a similar spinal deformity, is frequently associated with hydrocephalus, a disorder in which the brain accumulates fluid.
How is Meningocele Treated?
For many years, meningocele babies underwent surgery soon after birth to close the normal back tissues and protect the spinal cord. For some meningocele situations, fetal surgery is now an option. To gain access to the fetus, the operation entails accessing the mother’s uterus and abdomen.
The neural tube and other layers of the fetus’s back can then be closed by surgeons. The operation may stop further loss from happening for the duration of the pregnancy, even though it cannot restore already lost neurological function.
Does Meningocele have Long-Term Effects?
Meningocele often has a very good prognosis. To treat the issue, a simple surgical correction is usually sufficient. Meningocele normally has a good prognosis because it usually doesn’t affect the nerves and doesn’t cause any unexpected nerve-related problems. But once nerve fibres also come outside in the sac, the child will have a deficit depending on the number of nerve fibres
When Is It Time to Visit a Doctor?
A newborn may have meningocele or another type of spina bifida; therefore, you should contact a doctor right away if you notice any soft swelling on their back, neck, or lower spine. If the infant has trouble moving their legs, has trouble feeding, has trouble controlling their bowels or bladder, or exhibits symptoms of infection around the swelling, an immediate medical evaluation is also required.
Meningocele may be identified during pregnancy by prenatal imaging, enabling parents to seek specialised care before delivery. In addition to ensuring the child receives proper medical and surgical care, early diagnosis and prompt treatment can help avoid complications and improve outcomes.
Healing Following Meningocele Surgery
The child’s general health, the location of the spinal deformity, and the timing of treatment all affect how well they recover from meningocele surgery. To monitor wound healing and look for signs of infection or fluid leakage, most children stay in the hospital for a few days. Frequent follow-up visits help evaluate the child’s neurological development, growth, and mobility.
If necessary, physical treatment may be suggested to enhance coordination, strength, and mobility. Many children recover well and can have active, healthy lives with few long-term consequences if they receive timely surgery, appropriate rehabilitation, and continued medical care.
Trust Trishla Ortho for Comprehensive Meningocele Care
Meningocele is a curable form of spina bifida, and the greatest results depend on an early diagnosis. Parents can make informed decisions and seek prompt medical attention when they understand its causes, types, symptoms, diagnosis, and treatment.
In addition to lowering the risk of problems, prompt surgical intervention and routine follow-up can greatly enhance a child’s quality of life.
Our skilled pediatric orthopaedic specialists at Trishla Ortho offer thorough assessment, cutting-edge therapy, and considerate care customised to each child’s needs. With professional pediatric orthopaedic doctors, you can rely on our team to guide your child toward a healthier, more active future.
