Spina Bifida Disorder : Late Post Operative Result and Keypoints

Complex spectrum of vertebra, spine and brain anomalies with variable manifestation.

# Tailored Approach # Long follow up# Clarity in Counselling and Prognosis (neurological impact)# Emphasis on Preconceptional Counselling.

Term newborn 2.5 kg with very huge Lumbosacral Meningomyelocele.

Operated within 24 hours after preoperative work up.

Child responded well in subsequent follow up.

No postoperative neurological sequelae

Bowel Bladder : Normal ( No incontinence: Leaking urine, Fecal soiling)

Mother is expecting after preconception folate therapy and as per anomaly scan no signs of spina bifida in the expected baby.

TAKE HOME MESSAGE

• 1.SPINA BIFIDA NEEDS INDIVIDUAL APPROACH FOR MANAGEMENT
• 2. COUNSELLING AND PROGNOSTICATION IS CORNERSTONE PRIOR TO SURGICAL INTERVENTION
• 3. NEED FOR LONG TERM FOLLOW UP NEEDS TO BE EMPHASIZED STRONGLY AND THE MOTIVATED PARENTS SHOULD BE GIVEN THE BENEFIT OF SURGERY ELSE THEY BRING DISGRACE TO THE CHILD AND THE TREATING DOC WHO PUTS LOT OF EFFORTS.
• 4. IMPENDING HYDROCEPHALUS SHOULD BE FORESEEN AND ACTED ACCORDINGLY ( MEDICAL/ SHUNT)
• 5.BOWEL BLADDER MANAGEMENT SHOULD BE STARTED EARLY
• 6. PRECONCEPTION COUNSELLING IS MUST.
• 7 IN DETECTED CASES ANTENATAL COUNSELLING SHOULD BE DONE WITH PERSON HAVING VAST EXPERIENCE OF THE SUBJECT RATHER THAN DISCOURAGING PARENTS TO SEEK WHAT IS BEST SUITED.

Sharing the pre op and late follow up pics and child is doing well as per milestones over follow up on 1.7 years.