Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Developmental disease of spinal cord

congenital and developmental
treatment of spina bifida,tethered cord and syringomyelia

  • Login to see the comments

Developmental disease of spinal cord

  1. 1. A N D R E A Developmental disease of spinal cord
  2. 2. Embryology  Human nervous system develops from a specialized plate of cells along the back of the embryo  Early in the development the edges of this plate begin to curl up towards each other creating the neural tube  Anterior end becomes brain and the posterior become spinal cord.Complete by 28th day of pregnancy
  3. 3. Spina Bifida  SPLIT/CLEFT SPINE  Most common NTD  In lumbosacral region  1/1000 births
  4. 4.  What causes spina bifida?  Risk factors  Pathogenesis  Types-spina bifida cystica(open type) spina bifida occulta(closed type)
  5. 5. Spina bifida apperta  Myelocele-spinal cord is exposed so that the nerve tissue lies exposed on the surface of the back without even covering of meninges  Myelomeningocele-neural placode and meninges protrude above the skin.Almost always seen with Arnold Chiari 2 malformation  Hemimyelocele-myelocele+diastematomyelia  Hemimyelomeningocele
  6. 6. Spina bifida occulta  Often unnoticed  It can be associated with other conditions that could lead to problems with movements and bladder control  Meningocele  Lipomyelomeningocele  Dermal sinus  Diastematomyelia
  7. 7. Diagnostic evaluation  Neural tube defects can usually be detected during pregnancy by testing the mother's blood (AFP screening) or a detailed foetal ultrasound.  Increased levels of maternal serum alpha- fetoprotein (MSAFP) should be followed up by two tests - an ultrasound of the foetal spine and amniocentesis (to test for alpha- fetoprotein and acetylcholinesterase).
  8. 8. Treatment  There is no known cure for nerve damage caused by spina bifida.  The spinal cord and its nerve roots are put back inside the spine and covered with meninges.  In addition, a shunt may be surgically installed to provide a continuous drain for the excess cerebrospinal fluid produced in the brain, as happens with hydrocephalus.  Shunts most commonly drain into the abdomen or chest wall.
  9. 9.  Monitor growth and development  Treat and evaluate nervous system issues, such as seizure disorders.  Physical therapy  Speech therapy
  10. 10. Immediate Treatment  Place the child in prone position.  Cover the affected area with sterile gauze piece dipped in normal saline.  Maintain hydration.  Monitor for associated defects.
  11. 11. Neurological disorder caused by tissue attachments that limit the movements of spinal cord within spinal column. Tethered cord syndrome
  12. 12. causes Signs and symptoms  Myelomeningocele  Lipomyelomeningoce le  Dermal sinus  Diastematomyelia  Tumor  Lesion on lower back  Fatty tumor or deep dimple  Hairy patch  Back pain  Leg pain and numbness  Leg deformity  Spine tenderness  Scoliosis  Bowel and bladder problems
  13. 13. Diagnosis MYELOGRAM USG CT MRI
  14. 14. TREATMENT  If the patient has predominantly back pain and mild weakness, a course of physical therapy may provide tethered cord treatment.  In most cases, surgical treatment of tethered cord is needed to prevent neurologic deterioration. A laminectomy is performed, the dura is opened and using the operating microscope, the spinal cord is freed from the tethering structure.
  15. 15. Syringomyelia  Development of tubular CSF filled cavity in the substance of spinal cord  Can be congenital or acquired  Congenital-associated with Chiari 1 defect  Present with loss of pain and temperature in upper limb
  16. 16.  Treatment  Chiari defect decompressed by suboccipital craniectomy or upper cervical laminectomy  Large syrinx cavity –direct decompression or drainage
  17. 17. THANK YOU

×