A N D R E A
Developmental disease of
Human nervous system develops from a
specialized plate of cells along the back of the
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
Most common NTD
In lumbosacral region
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
Spina bifida occulta
It can be associated with other conditions that
could lead to problems with movements and
Neural tube defects can usually be detected
during pregnancy by testing the mother's
blood (AFP screening) or a detailed
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).
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.
Monitor growth and development
Treat and evaluate nervous system issues, such
as seizure disorders.
Place the child in prone position.
Cover the affected area with sterile gauze piece
dipped in normal saline.
Monitor for associated defects.
that limit the
causes Signs and symptoms
Lesion on lower back
Fatty tumor or deep
Leg pain and numbness
Bowel and bladder
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
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
Chiari defect decompressed by suboccipital
craniectomy or upper cervical laminectomy
Large syrinx cavity –direct decompression or