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Neurology (Expert Forum)
spinal surgery/ spina bifida occulta or Meningocele
Answered by
Lama Chahine, MD - Neurology
Cleveland Clinic
Cleveland - OH
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.
spinal surgery/ spina bifida occulta or Meningocele
by amber31, Jun 29, 2009 08:55AM
My son was born on October 9th of last year. while in the hospital my husband and I noticed a small mark about a inch from his butt . . we informed our doctors. later our new pediatrician told us she wanted to send us to a neurosurgeon so we did .. he got a MRI and the results were he had spinal bifida they wanting to do surgery on July 29th on his spine.. however; he has full function of his legs, he has good hand-eye coordination , he seems all together fine... do you think this surgery is necessary of should i wait until symptoms occur if they occur.. I feel that he has the occulta form which say that most the time its not even detected and they patients are just fine.. for some reason I feel like I should not get this surgery done.
Doctor's Answer
by Lama Chahine, MD, Jul 03, 2009 10:28AM
, Jul 03, 2009 10:28AM
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.
Without the ability to examine your son and obtain a history, I can not tell you what the best management plan would be for him. However I will try to provide you with some useful information.
There are many different types of spina bifida. The type is best determined based on the imaging study of the patient. As you mention, some patients with spina bifida occulta do very well without any type of surgery. However, even if all that is apparent externally is a small mark, internally, there may be other abnormalities that are not externally apparent. With good function of the legs, bowel, and bladder, the severity of the spina bifida is obviously less, but other complications can occur, such as tethered cord, scoliosis or kyhphosis (abnormal spine curvatures). Early surgery is sometimes useful in preventing long-term complications of these.
I am not a surgeon nor a pediatric neurologist, so further comment from my end is difficult. However, it is important for you to ask these questions to your son's team: what is the exact nature of his spina bifida, what are the advantages and disadvantages of having surgery now vs. later, etc. Regardless of whether or not surgery is done, physical and occupational therapy and testing to ensure proper bowel and bladder function is important.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
Without the ability to examine your son and obtain a history, I can not tell you what the best management plan would be for him. However I will try to provide you with some useful information.
There are many different types of spina bifida. The type is best determined based on the imaging study of the patient. As you mention, some patients with spina bifida occulta do very well without any type of surgery. However, even if all that is apparent externally is a small mark, internally, there may be other abnormalities that are not externally apparent. With good function of the legs, bowel, and bladder, the severity of the spina bifida is obviously less, but other complications can occur, such as tethered cord, scoliosis or kyhphosis (abnormal spine curvatures). Early surgery is sometimes useful in preventing long-term complications of these.
I am not a surgeon nor a pediatric neurologist, so further comment from my end is difficult. However, it is important for you to ask these questions to your son's team: what is the exact nature of his spina bifida, what are the advantages and disadvantages of having surgery now vs. later, etc. Regardless of whether or not surgery is done, physical and occupational therapy and testing to ensure proper bowel and bladder function is important.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
