By C. Sainte-Rose As we stand at the dawn of the 21st century, one may ponder the rationale of writing a book on spina bifida. Once commonplace in European countries prior to the era of ultrasonography, this disease became increasingly rare in developed countries as a - sult of improvements in antenatal diagnosis, to the point that we believed it to be d- appearing. Knowledge of spina bifida and of its treatment, once so richly diffused - ly 30 years ago, began to fade. Young neurosurgeons who had never seen such a m- formation at its initial presentation were hesitant, and did not understand the protean clinical signs of these patients presenting to the emergency department or outpatient clinics. This situation, however, did not last for long. As a consequence of the poli- cal and economic events of the final years of the 20th century, the advent of globa- sation, and the significant desire for immigration, we realised that spina bifida had not disappeared at all in the rest of the world. Migration was, and is, bringing it back - to our doorstep, to our everyday clinical and surgical practice. It is important the- fore, not to lose the knowledge gained by our masters, to try and assemble it in one place in order to understand the disease from its inception in utero through until adu- hood and the reproductive age.
Comprehensive yet concise reference book on spina bifida
Excellent high quality color figures, tables and diagrams
A must for any practitioner having to diagnose and treat this malformation
The evolution of technology has made new surgical techniques available for the treatment of diseases associated with the spina bifida malformation, and this is especially true in hydrocephalus and fetal surgery. The progress in this last field and in prenatal diagnosis have raised the significant problem of the effectiveness and usefulness of in utero surgical treatment of the malformation, that are extensively discussed in this volume. Also the clinical situations that can be seen in adolescents or young adults with spina bifida, including sexuality and pregnancy, are highlighted. Aim of this book is to promote a multidisciplinary approach to spina bifida, providing the three main specialists’ categories involved - neurosurgeons, orthopaedic surgeons, and urologists - with an updated overview of surgical approaches and with a concise reference that explains the main clinical problems to be faced in everyday clinical practice.
Introduction.- GENERAL CONSIDERATIONS: 1 A Historical Review of the Surgical Treatment of Spina Bifida.- 2 Embryology Applied to Neural Tube Defects (NTDs).- 3 Pathological Anatomy of Spina Bifida.- 4 Epidemiology and Aetiological.- 5 Myelomeningocele and Medical Ethics.- ANTENATAL DIAGNOSIS AND TREATMENT: 6 Diagnosis of Spina Bifida and Other Dysraphic States in the Fetus.- 7 The Role of Fetal Neurosurgery in Spina Bifida.- INITIAL MANAGEMENT: 8 Preoperative Care of the Newborn with Myelomeningocele.- 9 Radiological Evaluation of Myelomeningocele – Chiari II Malformation.- 10 Myelomeningocele Primary Repair Surgical Technique.- 11 Anesthesiology of the Newborn with Spina Bifida .- 12 Postoperative Care of the Newborn with Myelomeningocele.- 13 Early Surgical Complications of Spina Bifida.- 14 Vertebral Anomalies and Spinal Malformations in Myelomeningocele.- 15 Plastic Surgery Aspects of Large Open Myelomeningoceles.- 16 Pathophysiology of Hydrocephalus.- 17 Hydrocephalus in Myelomeningocele: Shunts and Problems with Shunts.- 18 The Treatment of Hydrocephalus in Spina Bifida – Endoscopy.- SECONDARY MANAGEMENT NEUROLOGY AND NEUROSURGERY: 19 Chiari II Malformation and Syringomyelia 20 Challenging Problems of Shunt Management.- in Spina Bifida 21 Supratentorial Cerebral Malformations in Spina Bifida.- 22 Tethered Cord in Children with Spina Bifida.- 23 Pathophysiology and Clinical Features of Tethered Cord Syndrome.- 24 Spasticity in Spina Bifida.- 25 Seizures in Children with Myelomeningocele.- ORTHOPEDIC PROBLEMS: 26 Management of Vertebral Problems and Deformities.- 27 Spina Bifida: the Management of Extremity Deformities in Myelomeningocele.- 28 Habilitation of Children and Young Adults with Spina Bifida.- 29 Independence in Mobility.- UROLOGY: 30 Neuro-Urological Management of the Neuropathic Bladder in Children with Myelodysplasia.- PSYCHOSOCIAL ASPECTS: 31 Sexuality, Sex, Pregnancy, and Spina Bifida.- 32 Intellectual Outcomes in Spina Bifida.- 33 AFamily Centered Evaluation of Psychosocial Agendas in Spina Bifida.- 34 Endocrine Aspects of Neural Tube Defects.- OCCULT SPINAL DYSRAPHYSM: 35 Anterior and Lateral Meningoceles.- 36 Spinal Lipomas.- 37 Neurenteric Cysts.- 38 Diastematomyelia.- 39 Spinal Dermal Sinuses.- Subject Index