Advertisement

Neural Tube Defects

  • Martin T. Corbally
Chapter

Abstract

Neural Tube Defects (NTD) or Spina Bifida are disorders of neural tube development and closure and include a wide variety of abnormalities ranging from spina bifida occulta to anencephaly. Although the incidence of neural tube defects is less common today (0.5–1/1000 live births in some reports) and is falling, NTDs remain the most common congenital central neural system developmental disorder. The factors contributing to this decreasing incidence are in some part geographic and related to antenatal screening and termination of pregnancy but also relate to improved nutrition and folic acid supplementation. Improved standards of living and a falling birth rate have also impacted on a declining incidence. Despite this Spina Bifida is a cause of major morbidity with significant implications to the quality of life of the child but which also impacts significantly on the wellbeing of the family unit as a whole. Not surprisingly the management of these children involves a multi-disciplinary team approach with significant input from specialist paediatric surgeons, neurosurgeons, urologists, orthopaedic surgeons, paediatricians (especially rehabilitation) social workers, nursing, physiotherapy and child psychology.

Keywords

Neural tube defects Spina bifida Encephalocoele Surgical management Outcomes 

Notes

Acknowledgments

Sincere thanks to Mr. John Caird, Consultant Paediatric Neurosurgeon and Dr. Claire Brenner, Consultant Paediatric Radiologist for permission to use their clinical photographs and Dr. Fatima AlOraifi, MRCSI, PhD for the art work.

References

  1. 1.
    Williams J, et al. Updated estimates of neural tube defects prevented by mandatory folic acid fortification—United States, 1995-2011. MMWR Morb Mortal Wkly Rep. 2015;64(1):1–5.Google Scholar
  2. 2.
    Medical Research Council Vitamin Study Group. Prevention of Neural Tube Defects. Lancet. 1991;338:131–7.CrossRefGoogle Scholar
  3. 3.
    Morgagni JB. Je Sedibus et causis morborum per indagatis. Typographia Simoniana: Naples; 1762.Google Scholar
  4. 4.
    Drake JM, et al. The shunt book. Cambridge: Blackwell; 1995.Google Scholar
  5. 5.
    Lorber J. Results of treatment of myelomeningocoele. An analysis of 524 unselected cases, with special reference to possible selection for treatment. Dev Med Child Neurol. 1971;13:279–303.CrossRefGoogle Scholar
  6. 6.
    Surana RH, et al. Are the selection criteria for the conservative management in spina bifida still applicable? Eur J Pediatr Surg. 1991;1(Suppl. 1):35–7.CrossRefGoogle Scholar
  7. 7.
    Romero R, et al. Accuracy of Ultrasound in the prenatal diagnosis of spinal anomalies. Am J Perinatol. 1989;6:320–3.CrossRefGoogle Scholar
  8. 8.
    Corbally MT. Spina bifida and encephalocoele. In: Puri P, Höllwarth ME, editors. Pediatric surgery: diagnosis and management. Berlin: Springer; 2009. p. 765–74CrossRefGoogle Scholar
  9. 9.
    Rudy DC, et al. The incontinent myelodysplastic patient. Urol Clin North Am. 1991;18:295–308.PubMedPubMedCentralGoogle Scholar
  10. 10.
    Kasabian NB, et al. The prophylactic value of clean intermittent catheterization and anticholinergic medications in infants and newborns with myelodysplasia at risk of developing urinary tract deterioration. Am J Dis Child. 1992;146:840–3.Google Scholar

Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of SurgeryRCSI Medical University, King Hamad University HospitalAl SayhBahrain

Personalised recommendations