Open spina bifida [Neurosurgery Wiki]

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====== Open spina bifida ======

The two forms of [[spina bifida]] are [[spina bifida occulta]] 

([[Lipoma]], [[Dermal sinus]] and thickened [[filum terminale]]).

and [[Open spina bifida]] or [[Spina Bifida Manifesta]] 

([[Myelomeningocele]], [[Myelocele]], [[Lipomyelomeningocele]]).

===== Treatment =====

[[Open spina bifida treatment]].

===== Case series =====

A cohort of fetuses with [[open spina bifida]] (OSB) who underwent open surgery in two fetal surgery centers ([[Argentina]] and  [[Mexico]]). Two groups were defined based on the [[gestational age]] (GA) at intervention: [[MOMS]] time window group: GA 19+0 -25+6 , and late intervention group: GA 26+0 -27+6 .

Intrauterine [[Fetoscopic Myelomeningocele Repair]] was successfully performed in 140 cases, either before (n=57) or after (n=83) 26 weeks, at on average 25.0 (22.9-25.9) and 26.8 (22.9-25.9) weeks, respectively. There were no significant differences in the rate of premature rupture of membranes, chorioamnionitis, oligohydramnios, preterm delivery, perinatal death and maternal complications. The late intervention group showed a significantly lower surgical times (112.6 vs. 124.2 min, p=0.01), lower interval between fetal surgery and delivery (7.9 vs. 9.2 weeks, p<0.01) and similar rate of hydrocephalus requiring treatment (30.6% vs. 23.3%, p=0.44) than the MOMS time window group.

Late fetal surgery for OSB repair between 26+0 -27+6 weeks is feasible and was associated with similar outcomes than that performed before 26 weeks. These findings may allow an extension of the proposed time window for cases with late diagnosis or referral
((Etchegaray A, Cruz-Martínez R, Russo RD, Martínez-Rodríguez M, Palma F, Chavelas-Ochoa F, Beruti E, López-Briones H, Fregonese R, Villalobos-Gómez R, Gámez-Varela A, Allegrotti H, Aguilar-Vidales K. Outcomes of late [[open fetal surgery]] for intrauterine [[spina bifida repair]] after 26 weeks. Should we extend the MOMS time window? Prenat Diagn. 2022 Feb 20. doi: 10.1002/pd.6119. Epub ahead of print. PMID: 35184313.)).
===1983===
Martinez-Lage et al. report the case of an infant who presented with an epidermoid tumor contained in a lumbosacral [[myelomeningocele]]. The association of [[spina bifida aperta]] and congenital intraspinal tumors is rare. Only two cases of teratoma and two cases of epidermoid tumors arising within a meningocele have been documented previously
((Martinez-Lage JF, Masegosa J, Sola J, Poza M. Epidermoid cyst occurring within
a lumbosacral myelomeningocele. Case report. J Neurosurg. 1983 Dec;59(6):1095-7. 
PubMed PMID: 6631508.
)).