Due to a defect in the spine, the meninges (covering the spinal cord), and even the spinal
cord may protrude and
may present as a swelling over the spine. The spinal defect
is called spina bifida. It is commonly present nearer the
lower end of the spine. In meningocele, only the meninges come out. If the cord also protrudes along with the meninges
as in meningomyelocele, the child may also have weakness of
the lower limbs and loss of control of the bowel and bladder functions. Hydrocephalus is also a possible
complication. If only the meninges are protruding, the outcome is much better.
TREATMENT: A child with any of these presentations should be urgently seen by a surgeon
(preferably a
paediatric surgeon or a neurosurgeon), who will decide if surgery
is indicated. In very severe cases, the surgeon may discuss
with the parents the poor long-term outcome in such cases and may avoid surgery.
