Cerebrospinal hernia in newborns: treatment

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Content

  • 1Cerebrospinal hernia in newborns
    • 1.1Causes of spinal hernia
    • 1.2Forms of spinal hernia in newborns
    • 1.3Symptoms of spinal hernia
    • 1.4Diagnosis of spinal hernia in newborns
    • 1.5Treatment of spinal hernia in newborns
    • 1.6Postoperative therapy
    • 1.7Prevention of spina bifida
  • 2What provokes the development of spinal hernia in newborns than it is dangerous
    • 2.1What is a spinal hernia?
    • 2.2Why a child is born with cerebrospinal hernia
    • 2.3What is dangerous spinal hernia in a baby
    • 2.4How to determine if a child has a spinal hernia
    • 2.5When spinal hernias are operated on newborns
    • 2.6Perinatal Surgery
    • 2.7Postpartum Surgery
    • 2.8Additional methods of surgical intervention
    • 2.9Where the operations on congenital cerebrospinal hernia are performed
    • 2.10What rehabilitation is needed after the operation
  • 3Cerebrospinal hernia is a congenital anomaly
    • 3.1Causes
    • 3.2Types and Classification
    • 3.3Diagnostics
    • 3.4Treatment
  • 4Cerebrospinal hernia in newborns: causes, treatment
    • 4.1Causes of spinal hernia
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    • 4.2Symptoms of spinal hernia in newborns
    • 4.3Treatment of congenital cerebrospinal hernia
    • 4.4Surgery
    • 4.5Conservative treatment
  • 5Herniated spinal cord in children and adults: causes, diagnosis and treatment
    • 5.1How serious is this disease?
    • 5.2Why can a hernia occur?
    • 5.3Types of spinal hernia
    • 5.4Symptoms of pathology in newborns
    • 5.5Symptoms of the disease in adults
    • 5.6How is the pathology diagnosed?
    • 5.7Conservative treatment of vertebral anomalies
    • 5.8Surgical removal of cerebrospinal hernia
    • 5.9Prevention of recurrence of the disease
    • 5.10Conclusion

Cerebrospinal hernia in newborns

Congenital spinal hernia is a rare but severe anomaly of development. This defect in the spinal cord is manifested only in 3% of newborns, and approximately two-thirds of them remain disabled for life.

Modern means of prenatal diagnosis allow to learn about the presence of splitting of the spine even during pregnancy.

For this, ultrasound data and additional analyzes for alpha-fetoprotein are used.

Final confirmation occurs during the study of amniotic fluid - amniocentesis.

Causes of spinal hernia

The question of the origin of the hernia of the spinal cord has not been studied enough. Because of this, various medical scientists called such factors that influence the probability of its appearance:

  • Deficiency of vitamins, and first of all, folic acid (vitamin B9). It is recognized by most researchers as the main cause of the disease;
  • A complex of factors provoking a variety of fetal abnormalities: taking alcohol and other drugs in time of pregnancy, intoxication of the body, infection of the future mother with certain infections and parasites, and gt;
  • Pregnancy at an early age;
  • Heredity.

The neural tube of the unborn child is formed in the first eight weeks of pregnancy. It is at this time that the effects of the above-described factors can provoke an inadequate infection of the back wall of the spinal canal.

Because of this, one or more vertebrae are separated in the zone of spinous processes.

In the resulting defect in the development of the fetus can come out hard spinal membranes, spinal fluid and even roots of nerves.

Forms of spinal hernia in newborns

Doctors share different cases of spinal hernia in their localization and structural features. The location of the defect plays a big role for the patient and the doctor treating him, since the severity of the symptoms and the difficulty of treating the pathology depend on this.

The easiest type of splitting, in which there is no hernia as such, is called latent (spina bifida occulta (lat.) - latent splitting of the spine).

In this case, an insignificant deformation of one of the vertebrae is diagnosed, which often does not cause any inconvenience to the patient.

In some cases, mild neurologic symptoms appear, but without significant health consequences.

A more serious defect in the structure of the spine provokes a hernial cleavage.

At the same time, prominence is clearly visible, extending beyond the skin. Most often it consists of meninges and fluid.

In the most severe cases, the roots of the hernia and the spinal cord itself exit.

Hernia of the spinal cord can belong to one of three types of localization:

  • In the cervical region - the rarest variant of a hernia. It affects the upper part of the spinal cord, which innervates the muscles of the neck, face and ligaments. Accordingly, the coordinating abilities of these and all lower divisions may be violated spine, which affects the motor activity of both upper and lower extremities, and also heart and lungs;
  • In the thoracic region - happens more often than in the cervical, but still much less often than in the lumbar. Violations of the neck, facial muscles and larynx are excluded, but the risk is, in addition to the limbs, respiratory system and heart, as well as internal organs (stomach, spleen, liver, 12-finger intestine);
  • In the lumbosacral region - the most common abnormality affecting the lower limbs, bladder and rectum, sometimes even the kidneys and genitals.

Regardless of where the splitting is located, the severity of the symptoms determines the degree of protrusion of the components of the spinal cord.

According to it, pathology is considered to be one of the four forms of cerebrospinal hernia:

  • Meningocele is an mild form of the disease characterized by the penetration of the spinal cord into the intervertebral defect exclusively of the spinal cord. The spinal cord itself remains correctly formed and capable;
  • Meningomielocele - in addition to the membrane, protrusion of the spinal cord substance is observed. The structure of the neural tube is broken, neurologic symptoms appear;
  • Meningoradiculocele - in the hole formed by the deformed vertebrae, it leaves the body both the membrane and the roots of the spinal nerves, although the neural tube remains in its place;
  • Myelocystocele - the most severe form of anomaly, in which the spinal cord from the inside is stretched cerebrospinal fluid, necessary for nutrition of cells and tissues of the nervous system). As a result, the structure of the spinal cord is almost completely broken, which is difficult to restore and any treatment.

In addition to all the forms described above, in very rare cases, the most severe of complications arises, caused by a combination of a hernia with a tumor.

Usually these are benign lipomas or fibroids, fixed on the membranes, rootlets or internal structures of the spinal cord.

The tumor does not degenerate into malignant formation, since it is removed along with bulging during surgery, or until this point, a fatal outcome occurs.

Symptoms of spinal hernia

Lack of tactile and / or pain sensitivity;

  • Paresis, paralysis and malnutrition of the lower and, in rare cases, upper limbs;
  • Dysfunction of the pelvic organs, in particular, the muscles of the bladder, anus and genitals.
  • Violation of the coordination of the work of the heart, lungs, digestive and endocrine system organs is rare when it comes to hernia in the cervical or thoracic spine.

The above symptoms lead to secondary complications:

  • Atrophy of paralyzed muscles, absence of their temperature regulation due to loss of skin sensitivity, swelling, trophic ulcers on the skin of immobilized limbs;
  • Flexion contractures (immobility of joints, which eventually becomes irreversible);
  • Bedsores in the buttocks and lower back;
  • Incontinence of feces and urine.

Diagnosis of spinal hernia in newborns

For an accurate diagnosis of spinal hernia, a full medical examination is required, which starts with an anamnesis.

In the case of contact with a doctor after childbirth, in which no pathologies were found, special attention is paid to the age indicators during the manifestation of symptoms of the disease (weakness in the limbs, signs of atrophy and hampered activity muscles).

The following diagnostic procedures are mandatory:

  • An examination at the neurologist, during which the assessment of motor activity, checking the muscle tone of the limbs, detection of protrusion and fixation of relevant medical indicators;
  • Transillumination is a special light scan, due to which it is possible to detect and characterize the contents of the hernial protrusion;
  • Contrast myelography is an intravenous injection of contrast medium that accumulates in certain parts of the spinal cord. Gives an idea of ​​the structure of damage to the spinal cord during the formation of a hernia;
  • Study of layered images of magnetic resonance or computed tomography of the spine, specifying data on the violation in the spinal cord and giving the possibility to predict the further development of pathology;
  • Consultation with a neurosurgeon for the purpose of ascertaining the feasibility of surgical intervention.

Treatment of spinal hernia in newborns

The only recognized method of treating spina bifida with spinal hernia is surgery.

Surgical intervention in this case is required as soon as possible, best of all - already in the first week of the patient's life.

To prevent the threat to the life and health of the newborn is possible only with the complete removal of the hernial sac and the removal of the defect between the deformed vertebrae.

In some cases, with mild forms of the disease (meningocele is small in size, which does not give violations motor activity and sensitivity, as well as maintaining the normal skin), the operation is required to postpone.

A hasty surgical intervention can result in damage to the important spinal structures, which will cause the same neurological disorders that need to be avoided.

Any other vertebral hernia requires urgent mandatory surgery.

Postoperative therapy

To transfer such an operation to any baby will require a long rehabilitation period.

The newborn needs careful care, maintenance of impeccable hygiene, therapeutic massages, physiotherapy, gymnastics and prevention of constipation.

The list of conservative measures also includes prophylaxis of pressure sores, training of urinary sphincters bladder and anal opening, treatment of spinal deformities and correction with supportive corsets.

Usually recovery from a spinal hernia occurs in one of two ways:

  • After the removal of the meningocele and the carrying out of all the required rehabilitation procedures, the development of the child continues normally. In most cases, such children grow up capable of leading an active lifestyle.
  • Elimination of the hernia meningomielocele, meningoradiculocele and meningocystocele can cause certain difficulties, both during the operation and after it. Proper compliance with the requirements of the rehabilitation period helps to avoid violations of the motor activity of the limbs, but to expect the same from the functions of the pelvic organs is not necessary. Incontinence of urine and feces can last much longer than in normal children. In adulthood, even if external signs of health persist, infertility is detected in women, and in men - erectile dysfunction.

Prevention of spina bifida

Since spinal hernia is a congenital anomaly of development, the prevention of this disease is the elimination of its causes even before conception.

The primary measure is to ensure the future child with all the necessary trace elements and vitamins.

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If even a pregnancy is unplanned, the use of drugs and related foods can begin after conception - the earlier, the better.

In the specific case of prevention of a hernia of the spinal cord, emphasis is placed on vitamin B9 (folic acid). It is interesting that this substance can enter the fetus not only from the mother, but also from the future father, as it is transmitted through the seminal fluid, while having a significant effect.

Any future mother should consult a gynecologist and consult about the diseases developing at the stage of fetal formation. The doctor should talk about ways to ensure a favorable bearing of the child.

For the beginning, the majority of pharmaceutical preparations are stopped for at least the first eight weeks, while the neural tube is formed in the embryo.

Also, do not get involved in cosmetics, the same applies to any household chemicals.

A source: http://kakbyk.ru/gryzha/spinnomozgovaya-gryzha-u-novorozhdennyh-detej/

What provokes the development of spinal hernia in newborns than it is dangerous

Severely responding to the methods of treatment spinal hernia in newborns, occurs in 60% of all cases of disorders of the musculoskeletal system.

Completely cure this disease in infants is impossible, but with timely measures taken, can reduce the number and intensity of complications and help the child lead a relatively normal a life.

What is a spinal hernia?

Cerebrospinal hernia in a newborn is a congenital disease, the etiology of which has not yet been clarified to the end. There is irrefutable evidence that the lack of vitamins and minerals in the body of a child can lead to the development of pathology.

The disease is often accompanied by clubfoot, hydrocephalus (hydrocephalus), as well as related diseases associated with violation of the urethra and digestive tract.

Congenital spinal cord hernia in the fetus in most cases is formed in the lumbosacral region, less often in the thoracic region. Depending on the clinical manifestations, it is common to distinguish several types of pathological disorders.

Congenital spinal hernias include:

  • Spina bifida occulta - a disease that is often detected by chance, because of the hidden crevices of the arches. At a pathology there is no hernial protrusion. Localization - sacral or lumbar. Closed spinal hernia is the easiest to treat.
  • Meningocele - localization in the sacral region of the spine. For pathology, the spine of the spine, the protrusion of the spinal cord envelope are characteristic.
  • Mielomeningocele - a characteristic difference of the disease is the involvement in the protrusion of not only the shell, but also the tissues of the spinal cord. The hernia looks like a brain plate locked into the tube. Gray and white matter has an irregular shape.
  • Mielocystocele - a serious form of the disease, with characteristic disorders of the structure of the spinal cord. The consequences of cerebrospinal hernia mielocystocele in infants are characterized by paresis of the lower limbs, impaired functions of the pelvic organs. Pathology is characterized by abundant accumulations of fluid entering through the greatly widened cleft of the vertebrae.
  • Rachischisis - a disease characterized by complete cleavage of membranes, cerebrospinal fluid, parts of the spine and soft tissues. Infant mortality with cerebrospinal hernia Rachischisis in newborns is 100%.

The diagnosis of "congenital spinal hernia in almost any case, means that parents will have to learn how to care for a sick child. Timely appointed and correctly conducted therapy increases the chances of a relatively normal development of the child.

Why a child is born with cerebrospinal hernia

As already noted, the causes of cerebrospinal hernia in a child have not yet been fully understood. Pathology is congenital, but the genetic dependence of the disease is excluded.

The appearance of a hernia is not affected by the fact that close relatives or parents had a similar deviation.

To date, the following causes of congenital hernia of the spinal cord have been identified:

  • Lack of essential substances for fetal development. Although the appearance of hernia is affected by many chemical and physiological factors, according to experts, the catalyst of the disease is a lack of folic acid in the mother's body.
  • Infectious diseases - at risk are newborns whose mothers have suffered an infectious disease at the very beginning of pregnancy. Infected spinal hernia occurs in approximately 20-30% of cases.
  • Traumatic factor - the cause of the disease are repeated abortions, trauma during pregnancy.
  • Psychosomatic diseases - it has been proven that stress and a serious emotional load often become a provoking factor or a catalyst for the onset of a hernia.

Treatment in newborns is associated with a risk of disability. To date, the best method of therapy is to prevent the development of the disease. Preventive measures include the proper daily routine, a competently chosen diet, minimizing stress during the entire gestation period.

What is dangerous spinal hernia in a baby

Cerebrospinal hernia practically does not give in to treatment. In domestic clinics, therapy is basically reduced to eliminating the consequences of the disease.

The outcome of the pathology is:

  • Disability - with qualified treatment, including surgical treatment, physiotherapy, special diet and massage, the child will be able to lead a relatively normal life. In case of complications, you will not be able to avoid a wheelchair. Often, in addition to paralysis of the limbs, involuntary urination and defecation are observed. The physical development of the child lags behind the normal, but in general, subject to competent treatment, he can get education and lead a full life.
  • Fatal outcome - hydrocephalus leads to constantly growing pressure inside the brain, eventually it leads to the death of the child. In severe cases (Rachischisis), a lethal outcome is observed due to the splitting of soft tissues and the spinal cord, as well as the transformation of the spine incompatible with life.

Self-healing ability of the child is absent. Instead of expecting a miracle, it is better to start a competent treatment as early as possible!

How to determine if a child has a spinal hernia

The disease is characterized by pronounced symptoms, which include:

  1. Paralysis of the extremities.
  2. Loss of sensitivity.
  3. Problems with urination and defecation
  4. Disorders of the internal organs: kidneys, intestines, bladder.
  5. Hydrocephalus.

Since the symptoms may indicate other diseases, differential diagnostics of congenital spinal cord hernia in children is carried out. To confirm the diagnosis, radiography or MRI is often required.

After the disease is examined, the code is assigned to the ICD and appropriate treatment is prescribed.

In the west, much attention is paid to the early definition of a hernia, during the development of the fetus.

This makes it possible to carry out a successful operation to remove the bulge and almost complete recovery of the child's health.

When spinal hernias are operated on newborns

Surgical treatment of congenital cerebrospinal hernias in children is performed either in the perinatal period, or even after the birth of the child.

Perinatal Surgery

It is considered the most effective method of surgical treatment. The operation is performed in the period of 19-26 weeks from the beginning of pregnancy. The essence of surgical treatment is reduced to the closure of an anatomical abnormality in the structure of the spine.

As a result, the spinal cord returns to the site, as much as possible protected from possible damage.

Management of labor with spinal hernia in the fetus is carried out with the help of caesarean section.

Natural birth can lead to a relapse of the disease.

As practice has shown, the consequences of perinatal surgery in infants are almost invisible. Care of the child is reduced to maintaining the normal working capacity of the intestine and bladder, and constant monitoring by a specialist.

Unfortunately, this kind of surgery, like the surgery of spinal hernias in preterm neonates, is conducted exclusively in the "Western" and Israeli clinics.

Domestic surgery centers are gradually introducing similar methods of treatment, but at the moment, only a few units of specialists are able to successfully carry out this type of operation.

Postpartum Surgery

After delivery, surgical intervention is effective only in the first few days. After this, it is possible to remove the growth, but after the operation a disability inevitably occurs.

Life after surgery in this case will be associated with the difficulties associated with the mental and physical retardation of the child. Over time, there may be a need for a second operation.

The results of treatment are affected by the intensity of growth and the severity of pathological changes. Lifespan depends on the type of hernia, as well as on the presence of hydrocephalus.

Additional methods of surgical intervention

During the recovery period of a child after an operation to remove a hernia, additional surgical intervention may be required:

  • Shunting - helps reduce the pressure of hydrocephalus on the child's brain and remove excess fluid.
  • Elimination of anatomical anomalies in the structure of the spine.
  • Orthopedic treatment.
  • Restoration of the bowel and bladder.

After the surgical treatment, in each case, a long rehabilitation is necessary.

Anesthesia during surgery is prescribed only after the definition of concomitant pathologies. Hernia can affect the functioning of the kidneys and liver of the newborn. In such cases, the appointment of anesthesia is treated with extreme caution.

Where the operations on congenital cerebrospinal hernia are performed

Orthopedic and rehabilitation clinics for the removal and treatment of the consequences of the removal of spinal hernia are found both in Israel and in Russia.

  • Israeli clinics - deal with this issue of neurosurgeons, leading the reception in the hospital. Rabin, MC Herzliya, as well as the children's health center Schneider.
  • In Russia, congenital spinal hernia is treated in any of the neurosurgical centers. Qualified help and consultation of specialists, concerning the anomalies of the spine in newborns, can be found in the Neurosurgery Clinic of the Children's Age of Russia. Polenov, located in St. Petersburg, on the street. Mayakovsky 12. Or at the Institute. Bechterew (st. Bechterew 3. St. Petersburg).

The results of treatment largely depend on the qualifications of surgeons, as well as on the degree of growth of the hernia. In approximately 30% of cases it is possible to achieve more or less stable state of health of the child.

What rehabilitation is needed after the operation

Usually rehabilitation centers are located directly near the clinics of neurosurgery and are a branch of the hospital. Large medical centers cooperate with sanatoriums for children. So, after treatment in the Israeli clinic, often resort treatment with spinal hernias, in a boarding house located on the shore of the Dead Sea. This allows the surgeon who performed the operation to monitor the patient's recovery process and make adjustments to rehabilitation methods. During recovery, the following procedures are performed:

  • Massage with a congenital hernia - helps to restore the mobility of the limbs, and also ensures the flow of blood to the damaged area. The features of the massage are that all movements are carried out particularly gently so as not to damage the bones of the child.
  • Exercises exercise therapy. After removal of the protrusion, the mobility gradually returns to the child. Physical exercises help to achieve a stable remission. The first classes are held in the water. If the gait of the child after spinal hernia is not restored, a wheelchair is appointed.
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Addresses of sanatoriums and rehabilitation centers can be found on the website of the clinic that conducts surgical treatment.

A source: http://ponchikov.net/health/pozvonochnik-i-sustavi/586-spinnomozgovaya-gryzha-u-novorozhdennyh.html

Cerebrospinal hernia is a congenital anomaly

Cerebrospinal hernia - congenital anomaly of the spine and spinal cord, occurs due to not fused between vertebrae, between them formed a lumen and part of the spinal cord with nerve roots, protruding between vertebrae.

In most cases, pathology occurs in the lumbosacral region, less often in the cervical, thoracic spine.This is a very serious illness and the clinic depends on the degree of insecurity of the nervous tissues of the vertebrae.

To date, spinal hernia is diagnosed in 50% of all lesions of the musculoskeletal system.

An abnormal defect can be identified even in the womb, this makes it possible to take preventive measures, even before the birth of the child.After discovering the pathology of the fetus, doctors are always advised to interrupt pregnancy.

But, not every mother will decide on such radical measures, so if a woman decided to give life to a baby, then right after birth it is required to begin treatment of a spinal hernia, this will help to prevent the presence of severe disability in future.

Causes

The clinic for today is not revealed by scientists. But it is known that a certain role in the correct development of the fetus is played by a lack of vitamins and microelements, especially in a large number of folic acid is required, for the proper formation of the nervous system the kid.

Negative influence on the formation of a hernia in the fetus has, uncontrolled use of drugs, the use of alcohol-containing drugs.

Cerebrospinal fluid forms in the first weeks of pregnancy, it is during this period of time, specific factors that can affect the appearance of a hernia of the spine in a future baby.

Types and Classification

The location of the spinal hernia is an important factor for the patient and the doctor. After all, it directly affects the life of a person and the complexity of treatment. Splitting of the spine is divided into the following types:

Hidden, manifests itself as an easy form of the disease course. Characterized by damage to the structure of one vertebra.

A person with this kind of hernia does not feel any special pain symptoms.The only thing, on the site of an unhealthy vertebra at a palpation a small depression is felt.

Visually in place of the disengaged vertebra, hyperemia with hairs is seen.

Herniated, this kind of pathology entails severe consequences and symptoms.

In addition to the fact that protrusion is visible to the unaided eye, it is classified as a neoplasm that is filled with cerebrospinal fluid, with nerve sprouts and ligaments.

In most cases, the nerve sprouts can fulfill their function normally, but if they are amazed, the baby is born with a complex of neuromuscular disorders and a number of somatic diseases.

In rare cases, each species can be accompanied by a complication in the form of a tumor.Basically, benign lipoma tumors are added to the hernia.

They are located on the shell of the spinal cord or on the processes of the intervertebral discs.

The tumor can not be converted into a malignant form, since it is removed together with the hernia during the operation.

Classification of the disease:

  • Meningocele (meninges). With such a pathology of symptoms from the side of the nervous system is not observed, because the brain is formed as it is necessary, solely, visually noticeable small tubercle on the vertebral column, covered with a thin skin cover. Symptomatics is characterized by the dimensions of the protruding spinal cord together with the nerve roots and the shells of the vertebral arches. The location of the localization and the contents of the tumor. The most encouraging prognosis is a small tumor with only Meningotocele bulging out;
  • Mielomeningocele - in this case the protrusion of the medullary membrane captures the tissues of the spinal cord (Mielomeningocele). Nerve roots partially enter the hernial tumor. As a result, the brain substance has irregular, curved forms;
  • Mielocystocele - a very severe form of the flow, involves a breakdown in the structure of the cerebrospinal fluid. Mielocystocele in infants is manifested by the paresis of the legs, a violation of the functions of the organs of the large and small pelvis. Hernia is characterized by the accumulation of cerebral fluid entering through a large aperture of the vertebral arches;
  • Rachischisis is the most severe and incurable pathology. It features a complete defeat of the spinal cord, vertebrae and soft tissues of the body. In this case, the brain is completely on the surface, and is not protected by the skin. According to statistics, 100% of babies end up flying.

Herniated spinal cord with various defects from the nervous system and paresis of the lower limbs. In most cases, it occurs with complications, in the form of involuntary urination and bowel movement.

A hidden form of pathology, is rarely manifested by any symptoms and disorders in the human body. Compared with open cleavage:

  • Paralysis of the lower extremities, complete or partial;
  • Hydrocephalus (fluid accumulation in the brain);
  • Disruption of the gastrointestinal tract, liver, kidneys;
  • Violation of the nervous system: epilepsy, nervousness, loss of body sensitivity;
  • Asymmetry and unnatural location of legs.

Diagnostics

The disease can be ascertained when the baby is still in the womb. And:

  • Pathology of the development of splitting of vertebral discs will be shown by ultrasound in perinatal research. The indication of a clinical study of blood and amniotic fluid of a pregnant woman for the presence of alpha-fetoprotein also indicates an abnormal fetal development;
  • After the birth of the baby spinal protrusion, it is visible not with an armed gaze. It looks like a bag, covered with a transparent skin with a liquid secret inside. In rare cases, the spinal part comes out;
  • For accurate diagnosis and refinement of the type of hernia, an X-ray examination is required, MRI or CT scan is used to detect concomitant disorders in the body;
  • The neurologic examination includes an evaluation of the muscle tone, the strength with which the child restrains the lower limbs on the surface, and the contents of the hernial sac are taken.

Treatment

There is an effective way to treat vertebral hernia,but unfortunately it is carried out only abroad.

The operation is performed when the fetus is in the womb for about 20 - 25 weeks of pregnancy.The essence of surgery is to close the pathology in the spine.

As a result, the spinal cord returns to its place, and the vertebral fissure closes. As statistics show, the consequences of perinatal intervention in a child after birth are rarely noticeable.

A timely withdrawal and performance of all the doctor's instructions, will ensure his life full and healthy person.

Congenital spinal hernia, it is very difficult to treat. Rarely cure and put the baby on its feet is possible in rare cases.

The patient should always be seen by the doctor, since the danger of complicating the disease will not disappear by itself.

If a spinal cord hernia is detected in a newborn, an emergency or planned operation is required, depending on the classification of the disease.

In most cases, surgery is performed in the first three days of the baby's life. Some of the luminaries of science are of the opinion that surgical intervention is not necessary.

The main thing is to make an important and right decision.

It is required to carry out a thorough study and diagnosis of the lesion taking into account all existing risks and complications after surgical intervention.

A source: https://pozvonochnik.guru/gryzha/spinnomozgovaya-gryzha.html

Cerebrospinal hernia in newborns: causes, treatment

Herniated spine is the most commonly acquired disease caused by many causes.

However, there are also congenital anomalies, in which, as a result of improper development of the fetus, defects develop before birth.

One such anomaly is spinal hernia in newborns.

The anatomical causes of this severe disease are the underdevelopment of the spinous processes of the vertebrae that form the spinal canal (the neural tube), in as a result of which they do not unite, and in the spine a splitting is formed, where the spinal cord or even the spinal cord with nervous processes. Spinal hernia is formed.

Causes of spinal hernia

Vertebrate cleavage has received the Latin name spina bifida.

There are three degrees of this defect

  • spina bifida occulta
  • meningocele
  • myelomeningocele
  • Spina bifida occulta is considered the lightest latent form of cleavage. No external protrusions are observed. In the spine - a hidden defect, expressed in the form of a gap in the place of non-rotation of the arcs. On the back there may be a fovea, a large pigmented spot or a patch with abundant embryology
  • Meningocele - the average degree of spinal hernia, at which only the spinal cord exits outwards. The output of the spinal cord and nerve endings does not occur
  • Myelomeningocele - the most severe dangerous degree of congenital defect: the part of the spinal cord is pushed outward together with the nerve roots

Symptoms of spinal hernia in newborns

  • Paralysis of legs
  • Loss of sensitivity below the level of hernia
  • Disturbed peristalsis of the intestine
  • Dysfunction of the kidneys, bladder and rectum
  • Hydrocephalus

Medical staff in maternity wards had to see such newborn babies with a sack-like formation on the back, most often in the lumbar-sacral department. Another sign is an inordinately large skull caused by hydrocephalus (a dropsy of the brain) - the accumulation of fluid inside the ventricles of the brain. The reason - in the broken circulation of the cerebrospinal fluid caused by a congenital defect - spinal hernia.

Hydrocephalus leads

  • to slow development
  • severe headaches and neurological disorders
  • convulsions
  • epilepsy
  • weakness of the extremities
  • poor vision, strabismus, rolling up pupils
  • in the end (with increasing pressure on the brain) - to death

Biological causes of anomalies

The biological causes of cerebrospinal hernia are not fully understood, but according to the results of long-term observations, the doctors came to the conclusion that, on the whole, the causes could be:

  1. Genetic abnormalities
  2. Postponed severe illness during pregnancy
  3. Inadequate intake of folic acid - the most important vitamin for a pregnant woman
  4. The use of alcohol by the mother, medicines, chemical poisoning
  5. Too young mothers

Thank God that such a defect is observed quite rarely: approximately 0.1- 0.2% of the total number of newborns, that is, approximately one to two babies per thousand.

Birth with such trauma often dooms the child to complete disability, since we do not actually treat the spinal cord hernia of newborns.

The meaning of treatment is often reduced only

  • to control hydrocephalus
  • hygiene procedures
  • the appointment of a special diet
  • physiotherapy

Therefore, all women at risk must undergo a particularly careful monitoring of the future child's development and constantly visit the doctor.

And remember that the health of the baby largely depends on them, and it is criminal during pregnancy to drink, smoke, consume highly effective drugs, neglect the vitamins.

Treatment of congenital cerebrospinal hernia

Qualitative diagnosis and treatment of cerebrospinal hernia of newborns is currently carried out only in Western clinics.

The main emphasis foreign doctors have made on prenatal treatment of moderate and severe degree of spinal hernia:

Treatment takes place in the womb until it is born.

And this is a very reasonable decision, since almost all the symptoms of this disease, except for the loss of sensitivity, if it already exists, can be eliminated with the help of a surgical prenatal operation.

The end of the formation of the spinal canal falls on 7 - 8 weeks of pregnancy, during this period, and you can determine the presence of an abnormality in the fetus.

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Prenatal diagnosis of cerebrospinal hernia is as follows:

  • The mother's blood is analyzed for alpha-fetoprotein (germinal protein)
  • Conducted ultrasound of the fetus
  • A puncture of the amniotic bladder (amniocentesis)

Surgery

Surgical prenatal treatment is conducted between the 19th and 26th week of pregnancy and consists in closing the anatomical defect in the fetal spine. This allows you to "return" the spinal cord to its place, where it will be protected from further damage.

After the operation, births are not recommended in a natural way: in order to prevent birth trauma, it is better to resort to a caesarean section.

For the same babies, who, unfortunately, did not notice the hernia prior to delivery, and they came into existence with this anomaly, another scheme of surgical treatment was developed:

  1. Treatment of hydrocephalus by shunting
  2. Elimination of anatomical defects of the spine
  3. Orthopedic treatment of scoliosis, bone and joint deformities arising from spinal hernia, and other problems
  4. Restoration of intestinal peristalsis and bladder work

Conservative treatment

Conservative treatment of spinal neovascular hernia is aimed at stopping the deformation of the spine and retaining mobility. It includes:

  • Therapeutic physical training
  • Physiotherapy
  • Wearing supporting corsets
  • Procedures to control the functioning of the intestine and bladder

This approach is aimed at improving the quality of life of the baby, as much as possible its independence and for the future free entry into the society.

A source: https://ZaSpiny.ru/gryzha/grizha-u-detey.html

Herniated spinal cord in children and adults: causes, diagnosis and treatment

Cerebellar hernia is a rather severe pathology, which is a congenital anomaly, as a result of which the vertebrae do not close, but form a gap.

Because of this, parts of the spinal cord and its membrane come out under the skin. Most often this pathology is formed in the lower part of the spinal column, but can also occur in other places.

This is a very serious disease, the severity of which depends on how much the nervous tissues are deprived of protection.

How serious is this disease?

Today, cerebrospinal hernia is diagnosed in the intrauterine period, which allows taking preventive measures before the birth of the child.

Almost always splitting of the spine is an indication in order to interrupt pregnancy, as spinal hernia in newborns is considered a very serious developmental malformation.

But if the woman still made a decision to give birth, then after childbirth the child is prescribed radical treatment to prevent the development of severe disability.

Spinal hernia in adults is also accompanied by severe disability, because it does not allow the movement of lower limbs and leads to incontinence of urine and feces. A person without help simply can not exist.

Why can a hernia occur?

The causes of splitting of the spine have not yet been fully elucidated.

The fetus during intrauterine development can be influenced by various factors: chemical, biological, physical.

Most scientists came to a consensus that the emergence of spinal hernia, perhaps, leads to a lack of vitamins in the body of the mother, in particular, folic acid.

Although splitting of the spine is a congenital pathology, but by its nature it is not considered genetic. However, if a child with such an anomaly was already conceived, then in the subsequent pregnancy the risk of its occurrence is great.

To prevent conception of the next child with a split spine before the onset of pregnancy a woman must undergo preliminary training, using a set of all necessary vitamins and minerals.

In an adult human spinal cord hernia arises from falling from a height, lifting weights, as a result of a collision or impact.

Types of spinal hernia

Such pathology is of the following types:

  • Hidden, which is characterized by mild form and a violation of the structure of only one vertebra. Most people who have a similar kind of hernia, no symptoms, only in the area of ​​the affected area of ​​the spine there is a slight depression.
  • Hernia, which causes a serious defect in the bones. Pathology has an external manifestation, expressed in a hernial protrusion with the spinal cord in it, along with the membranes and cerebrospinal fluid. Most often, nerve roots and trunks are not damaged and continue to function normally. In more severe cases, a spinal cord entrapment may occur in the hernial sac along with the membranes, trunks, and nerve roots. In this case, the pathology is accompanied by severe disturbances in motor activity and sensitivity.

Symptoms of pathology in newborns

Congenital spinal hernia manifests itself as follows:

  • paralysis of the legs;
  • impaired intestinal motility;
  • loss of sensitivity below the place of hernia formation;
  • a violation of the bladder, kidney and rectum.

Another symptom characterized by spinal hernia in children is a very large size of the skull, caused by dropsy of the brain (hydrocephalus), that is, inside the ventricles of the brain there is accumulation liquid. It contributes to this violation of the circulation of cerebrospinal fluid, which is caused by cerebrospinal hernia.

Hydrocephalus often leads to seizures, delayed development, epilepsy, neurotic disorders, severe headaches, strabismus, poor vision, rolling up pupils, weakness of the extremities. With a very strong pressure of the liquid on the brain, death occurs.

Symptoms of the disease in adults

Herniated spinal cord in an adult is characterized by the following symptoms:

    • Numbness of the skin on the foot, thigh or lower leg, feeling of numbness or tingling.
    • Painful sensations when bending.
    • The complexity of controlling the muscles of the foot, thigh, shin.
    • Severe pain that occurs in the lumbar spine, giving to the legs, stomach, groin area.
    • Intensified sweating.

How is the pathology diagnosed?

Diagnosis of a hernia begins with the collection of a medical history: the age at which weakness in the lower extremities and there was a thinning of the leg muscles, and also when the movement became very difficult.

The patient must necessarily turn to a neurologist who assesses the strength of the motor activity of the lower limbs, how much muscle tone is lowered in the legs, and also examines the spinal column to reveal the external hernial protrusion.

Diagnosis of hernia includes:

  • Transillumination, with which the contents of the hernial sac are evaluated.
  • Contrast myelography. In this case, evaluate how badly damaged the spinal cord, introducing for this intravenously a contrast substance, which begins to accumulate in the hernia;
  • Computer and magnetic resonance imaging, used in the area of ​​the spine to layer-by-layer to study the spinal cord. The obtained data allow to reveal a pathological region in the structure of vertebral canals and the place where the hernia and its contents are located.

It is also necessary to consult a surgeon and genetics.

Identification of the anomaly in the fetus during intrauterine development is carried out as follows:

  • with the help of a planned ultrasound during pregnancy;
  • delivery of blood tests for the maintenance of alpha-fetoprotein by a woman during the period of gestation;
  • Study of amniotic fluid by puncturing the membranes.

The decision on whether to interrupt pregnancy or not, makes a consultation of doctors, based on the severity of the pathology and desire of the woman herself.

Conservative treatment of vertebral anomalies

Herniated spinal cord is a very serious ailment, therefore any kind of traditional methods of treatment are categorically prohibited, visiting saunas and baths, drinking alcoholic tinctures, hot compresses, as well as hot baths with medicinal herbs. All this can greatly worsen the patient's condition.

Treatment of spinal hernia is done only in a radical way - removing pathology. A conservative method of treatment is necessary in order to prevent the progression of the anomaly.

For this, neurotrophics and nootropics are used, which normalize the work of the nervous tissue.

It is necessary to take vitamins A, B, C, E, which contribute to the improvement of metabolic processes in the areas of the spinal cord affected by the disease.

Also recommended are physiotherapeutic procedures (laser, magnet) that help restore motor activity.

With the help of physiotherapy in the affected areas, neuromuscular bonds are restored. Thanks to dietary nutrition the work of the intestine is normalized.

Be sure to include in the diet more coarse fiber (porridge, vegetables).

Surgical removal of cerebrospinal hernia

Many patients are afraid of carrying out the operation, but in most cases this particular method of treatment helps to get rid of the hernia until the nerve centers are affected.

Surgical intervention is absolutely necessary if unbearable pains occur, fecal and urinary incontinence occurs, a person begins to move with difficulty, and only pain relievers save him.

The operation (spinal hernia surgical removal) consists in the reconstruction of the defect of the spine, the closing of the hole of the bone tissue. If the hernial sac has nonviable tissues, they are removed, and healthy structures of the spinal cord are placed in the vertebral canal.

In most cases, the disease accompanies hydrocephalus, which after some time contributes to irreversible changes in the brain.

To prevent the detrimental effect of strong intracranial pressure, a shunt is formed, which is necessary to divert the CSF into the lymphatic duct.

Prevention of recurrence of the disease

To my great regret, there is a high probability that the spinal cord is formed again, in the same place or in some other way.

Therefore, when performing therapeutic gymnastics, you need to listen to your sensations arising during the extension of the spine.

Pain during the exercises should in no case be strengthened, but, conversely, reduced.

Newborns and adults are selected for a course of drugs that better nourish the tissues of the spinal cord. Children need to visit a neurologist regularly for preventive examination.

If the muscular corset begins to weaken, and also the wrong posture arises, then after a while this can lead to the fact that the load on the spine will be mis-distributed, provoking the formation hernia.

Therefore, it is very important to take care of the treatment with all responsibility and contact the doctor as soon as possible.

Conclusion

Hernia of the spinal cord is a severe defect in the fetal development of the fetus, often causing persistent disability and the occurrence of complications that are incompatible with life.

It is treated only surgically, but even this method does not give any guarantee that the hernia will not form again.

Therefore, before planning a pregnancy, a woman should see a doctor for all necessary examinations and follow-up recommendations.

A source: http://.ru/article/244423/gryija-spinnomozgovaya-u-detey-i-vzroslyih-prichinyi-diagnostika-i-lechenie