Meningocele is a rare form of spina bifida, a birth defect of the neural tube (the structure that forms during early fetal development to eventually become the brain and spinal cord). It occurs when a portion of the neural tube fails to close completely, resulting in a sac-like protrusion of the meninges (the protective covering of the brain and spinal cord) and the spinal cord itself through the vertebrae. Meningocele can be detected during an ultrasound in the second trimester of pregnancy. It is important to note that the spinal cord is not involved in the protrusion and is usually not affected.
Meningocele is classified into two types: open and closed. In an open meningocele, the protrusion is visible and the meninges and spinal cord are exposed to the outside environment. In a closed meningocele, the protrusion is covered by a thin layer of skin. The severity of the condition depends on the size of the protrusion, its location, and the amount of damage to the surrounding tissue.
Approximately 75 percent of meningoceles occur in the lumbosacral region (the lower back) and 25 percent occur in the cervical region (the neck). Depending on the size and location of the meningocele, the amount of damage to the spinal cord, and the presence of other associated birth defects, treatment may include observation, surgery, physical therapy, and/or medications.
Surgery is the most common treatment option for meningocele. The goal is to remove the sac and close the opening in the vertebrae, thus preventing further damage to the spinal cord. While surgery can be successful, the associated risks include nerve damage, infection, and paralysis.
It is important for people with meningocele to receive regular follow-up care, including physical therapy and monitoring of their neurological function. In some cases, additional surgeries may be necessary to correct complications or to improve function.
In conclusion, meningocele is a rare form of spina bifida that is usually detected during pregnancy. Treatment typically involves surgery to remove the sac and close the opening in the vertebrae. Regular follow-up care is important to monitor neurological function, and additional surgeries may be needed.
References
Berkhout, J. E., Van den Broek, P. J., & Wijnen, R. M. (2014). Meningocele: A Review. Frontiers in Neurology, 5, 1–7. https://doi.org/10.3389/fneur.2014.00036
Hoffman, J. M., & Spence, A. J. (2013). Spina Bifida: Diagnosis, Management, and Outcomes. American Family Physician, 88(10), 674–681.
Tutay, C. L., Bracken, R. B., & Rutka, J. T. (2013). Meningocele in Children: Neurosurgical Evaluation and Management. Current Neurosurgery Reports, 11(2), 135–141. https://doi.org/10.1007/s11910-013-0356-3