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Wheeless' Textbook of Orthopaedics
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Spina Bifida



- See:
      - Vertebral Defects:
      - Myelodysplasia:

- Discussion:
    - Spina Bifida refers to a local failure of primordia of the two laminae to unite leaves vertebral canal open
            dorsally (spinal rachischisis, or spina bifida);
    - dorsal body wall may or may not be intact over open vertebral canal;
    - sub-types:
            - spina bifida occulta:
                  - defect involves primarily bone, but skin may be attached to Dura, spinal cord, or nerve roots by fibrous bands;
            - spina bifida cystica:
                  - neural tissue may be exposed (myeloschisis)
                  - meninges may protrude (meningocele)
                  - spinal cord may protrude (myelomeningocele);
    - diastematomyelia:
            - related to spina bifida is condition known as diastematomyelia, in which the spinal cord is split by bony spicule or a fibrous band,
                  w/ each portion surrounded by a dural sac;
            - as child grows, a long spicule of bone or a fibrous band may tether spinal cord and produce neurologic deficits;





Orthopaedic management of high-level spina bifida. Early walking compared with early use of a wheelchair [see comments

The high incidence of foot deformity in patients with high-level spina bifida.

Mazur JM, Menelaus MB, Hudson I, et al: Hand function in patients with spina bifida cystica.   J Pediatr Orthop 1986;6:442.

Stillwell A, Menelaus MB: Walking ability in mature patients with spina bifida.   J Pediatr Orthop 1983;3:184.

Congenital abnormalities of the urogenital tract in association with congenital vertebral malformations
      A. S. Rai. JBJS-Br: Volume 84-B Number 6 August 2002  







Original Text by Clifford R. Wheeless, III, MD.