A myelomeningocele with spina bifida in the thoracic region is a relatively rare, congenital anomaly. This case, which we have experienced recently, is reported with a review of the literatures.
Meningomyelocele* ; Spinal Dysraphism

The authors report a case of thoracic meningomyelocele. The patient had not have any presenting symptoms until adult age. We confirmed it with radiological(postmyelography CT and MRI) and pathological diagnosis. Pre-, post- and intraoperative SSEP(somatosensory evoked potential) monitoring were performed. Characteristically, the mass contained accessory cord which attached to inner cyst wall with multiple fibrous bands. Meningomyelocele was completely removed without any neurologic sequelae.
Adult ; Diagnosis ; Humans ; Meningomyelocele*

No abstract available.
Arnold-Chiari Malformation* ; Meningomyelocele*

No abstract available.
Biofeedback, Psychology* ; Humans ; Meningomyelocele*

The Currarino triad is a unique complex of congenital anomalies including anorectal malformation, scral bonyabnormality, and presacral mass. The usual symptomatology is constipation due to anorectal stenosis. Threepatients with this triad confirmed by surgical operation during recent two yeas in Seoul National Universitychildren's Hospital were presented with a brief review of clinical features, unique radiologic appearance andpostulated pathophysiology. The presacral mass was a mature teratoma in the first patient, alipomyelomeningocele-epidermoid inclusion cyst in the second patient, and myelomeningocele in the third patient. Acorrect diagnosis of the Currarino triad by radiologists is important, and may help the phsicians to investigatedetailed family history and associated anomalies and to establish adequate surgical plans.
Constipation ; Constriction, Pathologic ; Diagnosis ; Humans ; Meningomyelocele ; Seoul ; Teratoma

Aplasia cutis congenita is a rare disorder characterized by localized or generalized absence of skin at birth. Group 4 in Friden's classification, which is associated with embryologic malformations including myelomeningocele, encephalomeningocele, omphalocele, gastroschisis. The authors have experienced a case of aplasia cutis congenita of right frontal scalp associated with bony defect, forming encephalocele in a newborn. We reported this case with brief review of literatures.
Classification ; Ectodermal Dysplasia* ; Encephalocele ; Gastroschisis ; Hernia, Umbilical ; Humans ; Infant, Newborn ; Meningomyelocele ; Parturition ; Scalp ; Skin

OBJECTIVE: To investigate the effect of surgery time on prognosis of newborns with meningomyelocele. METHODS: The records of neonates with meningomyelocele were retrospectively analyzed. Demographic and clinical characteristics as well as information, timing of surgery, and durations of hospital stay and antibiotic therapy were recorded. RESULTS: The records of 30 babies were included in the final analysis. Overall, the mean gestational age was 37.7+/-2.7 weeks, with a mean birth weight of 2967+/-755 g and head circumference of 35.8+/-3.8 cm. In terms of localization, 46.6% of the meningomyeloceles were lumbosacral, 40% were lumbar, 10% were thoracolumbar and 3.3% were thoracal. The mean size of the meningomyelocele sacs was 4.33+/-1.2 cm. Newborns underwent surgery on average of 8.2+/-5.9 days after birth, with an overall mean duration of hospital stay of 30+/-25.1 days. Patients were divided into two groups based on timing of surgery (group 1, < or =5 days; group 2, >5 days), and comparisons between groups revealed that earlier surgery was associated with significantly shorter durations of hospital stay (p<0.001) and antibiotic therapy (p<0.05). CONCLUSION: Early surgical intervention (< or =5 days) was associated with a shorter duration of hospital stay and antibiotic therapy as well as a lower complication rate. We recommend that corrective surgery be undertaken as soon as reasonably possible.
Birth Weight ; Gestational Age ; Head ; Humans ; Infant, Newborn ; Length of Stay ; Meningomyelocele ; Parturition ; Prognosis ; Retrospective Studies

PURPOSE: As problem have developed with the right colonic antegrade enema procedure (Malone's procedure/Monti's retubularized ileocolostomy), left colonic antegrade continence enema (LACE) procedure, in which retubularized ileum or sigmoid colon is anastomosed into the sigmoid colon, has gained popularity. The aim of the study was to describe our experience with the LACE procedure. METHODS: We retrospectively reviewed 19 LACE procedures that were performed at the Yonsei University Colllege of Medicine Hospital (Seoul, Korea) from March 2001 to March 2005. RESULTS: Male-to-female ratio was 11 : 8, with median age of 10 years (range, 3~34 years). Most common diagnosis was meningomyelocele (78.9%, 15/19). The median total follow-up period was 23 months (range, 3~37 months); median antegrade continence enema volume used was 600 ml (range, 250~1,500 ml); and median transit time was 30 minutes (range, 15~60 minutes). Patients performed antegrade continence enema with an average of once every 2 days (range, 0.3~3 days). Social continence was achieved in 14 patients (73.7%). Regurgitation of fecal material through stoma was not reported at all in 17 patients (89.5%). CONCLUSION: We recommend LACE as the procedure of choice for patients with congenital malformation or any other condition predisposing to fecal incontinence or constipation intractable to conventional treatment.
Colon* ; Colon, Sigmoid ; Constipation ; Diagnosis ; Enema* ; Fecal Incontinence ; Follow-Up Studies ; Humans ; Ileum ; Meningomyelocele ; Retrospective Studies

PURPOSE: This study was undertaken to ascertain if the Churchill's classification of the bladder, in children with spina bifida, reflects the characteristic clinical manifestation of the patients, and can therefore help to determine the best corrective surgical procedure in patients with spina bifida. MATERIALS AND METHODS: The patient population consisted in 148 lipomeningomyelocele and 92 meningomyelocele patients. Patient bladders were classified, according to Churchill, based on the filling, holding and voiding abnormalities(types I-V). The renal damage was expressed as grades A-D, according to the severity of the defect. RESULTS: Ninety patients were classified as type I and 5(6%) of them had renal damage. Thirty-three patients were classified as having type II and 7(21%) of them had renal damage. Five patients were classified as having type III, all with normal kidneys. Of these 5 patients, 2 received ileal augmentation and anti-incontinence surgery. 55 patients were classified as having type IV bladders and renal damage was found in 11(20%). Fifteen patients received augmentation and anti-incontinence surgery simultaneously. Two patients underwent ileal augmentation only, but incontinence continued postoperatively. Fifty-seven patients were classified as having type V bladder, and renal damage was found in 25(44%), and 15 patients received augmentation. All the type V patients that had augmentation cystoplasty maintained their continence state postoperatively. CONCLUSIONS: Neurogenic bladders in pediatric patients with spina bifida can be classified by Churchill's classification. The individual types showed characteristics of the clinical state. This classification seems to help in determining the best corrective surgical procedure in individual neurogenic bladder types of pediatric patients with spina bifida.
Child ; Classification* ; Humans ; Kidney ; Meningomyelocele ; Spinal Dysraphism* ; Urinary Bladder ; Urinary Bladder, Neurogenic*

"The prenatal diagnosis of spine bifida include the combined use of maternal serum alpha-fetoprotein (MSAFP) screening and fetal sonography. Sonographically, spina bifida is characterized by direct signs of the visualization of the spinal defect, and indirect signs of the cranial markers : the lemon sign, the banana sign, and ventriculomegaly. These ultrasonographic signs are more accurate in defining the cranial malformations associated with spina bifida than evaluation of the spine. Recently, three cases of spina bifida which was diagnosed as ""splaying"" of the posterior ossification centers, meningomyelocele sac at the lumbosacral area, lemon sign, banana sign and ventriculomegaly by ultrasonography at 21+2 gestational weeks in a 32 years old nullipara, at 21+2 gestational weeks in a 26 years old nullipara, at 23+6 gestational weeks in a 26 years old multipara were experienced at our department. We present this cases with a brief review of literatures"
Adult ; alpha-Fetoproteins ; Humans ; Mass Screening ; Meningomyelocele ; Musa ; Prenatal Diagnosis ; Spinal Dysraphism* ; Spine ; Ultrasonography