Systematic Classification of Spina Bifida

Schindelmann, Kim Hannah; Paschereit, Fabienne; Steege, Alexandra; Stoltenburg‐Didinger, Gisela; Kaindl, Angela M.

doi:10.1093/jnen/nlab007

Cited by 7 publications

(6 citation statements)

References 39 publications

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“…et al showed that myeloschisis is not as rare as it is believed but rather a common NTD. Contrary to literature, their results showed that myeloschisis (31%) occurred more frequently than myelomeningocele (23%) [14]. Therefore, the distribution and classi cation of NTDs show signi cant variations between different studies.…”

Section: Discussionmentioning

confidence: 77%

Determining Hydrocephalus and V-P Shunt Requirements After Repair of Myelomeningocele and Myeloschisis Defects in Infants

ŞERİFOĞLU,

ETLİ,

Işık

et al. 2024

Preprint

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Aim Myelomeningocele (MM) and Myeloschisis (MS) are important developmental defects requiring surgical treatment. Although there are defined differences between both lesions, the treatment and follow-up processes are the same. Hydrocephalus has an important place among the complications that may develop after surgical closure of the defect.Purpose Analysis of factors that may determine the need for shunting in the postoperative period in patients with MM and MS defectsMethod A retrospective analysis of 100 patients (60 females and 40 males) who were treated for MM and MS between the years 2013 to 2023 at our institution was conducted. The infants were divided into two groups: Group 1; those who underwent V-P shunt surgery following MM or MS repair surgeries (n = 81) and Group 2; those who did not receive V-P shunt surgery following MM or MS repair (n = 19). Parameters such as head circumference, MM sac integrity, MM sac size, MM sac location, and birth weight were examined. The results were analyzed to identify any potential differences between the two groups.Results We included 100 patients with myelomeningocele (MM, n = 86) or myeloschisis (MS, n = 14) abnormalies in this study. The rate of V-P shunt insertion was significantly higher in infants with preoperative hydrocephalus, those with an open myelomeningocele sac structure and those with abnormalies in the thoracic/thoracolumbar region.Conclusion In infants born with myelomeningocele or myeloschisis, determining the development of hydrocephalus and the need for V-P shunt placement after the repair of the defect is crucial. This evaluation helps in planning the management of these patients, aiming to minimize complications and to improve the overall prognosis.

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Section: Discussionmentioning

confidence: 77%

Determining Hydrocephalus and V-P Shunt Requirements After Repair of Myelomeningocele and Myeloschisis Defects in Infants

ŞERİFOĞLU,

ETLİ,

Işık

et al. 2024

Preprint

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“…From January 2018 to September 2022, 24 patients with MMC underwent initial repair surgery at Fukuoka Children’s Hospital. At surgery, an open (dysplastic) NP, that is myeloschisis, or a dysplastic CM was resected at the intermediate zone which consists of pia-arachnoid membrane between the neural structure and the surrounding skin[ 9 , 20 ] under a microscope. The resection line was placed with a space between the skins to avoid remnants of dermal elements, paying attention to minimize the damage of neural structures.…”

Section: Methodsmentioning

confidence: 99%

Histopathological presence of dermal elements in resected margins of neural structures obtained from initial repair surgery for myelomeningocele

Murakami

Kurogi

Suzuki³

et al. 2023

Surgical Neurology International

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Background: Development of dermoid or epidermoid cysts in myelomeningocele (MMC) sites is generally thought to occur in a delayed fashion due to implantation of dermal elements during initial repair surgery. Another theory is that dermal and dermoid elements may already be present within dysplastic neural structures at birth. Methods: We experienced histopathological presence of dermal elements in resected tissues at initial repair surgery in four out of 18 cases with MMC who required resection of parts or margins of the neural structures to perform cord untethering. Since one of these cases has already been reported, we describe the clinicopathological findings for the remaining three cases. Results: In Case1, cryptic dermoid elements were discovered in the terminal filum-like structure (FT-LS) caudal to the open neural placode (NP). The FT-LS had histopathological characteristics similar to the retained medullary cord. In Case 2, dermoid elements were discovered in the caudal margin of the dysplastic conus medullaris. In Case 3, a thin squamous epithelial layer overlapped the rostral margin of the NP where the NP was located near the skin. Case 1 developed an epidermoid cyst at 1 year and 2 months of age, which was totally resected. Conclusion: Prenatally existing cryptic dermoid elements in the caudal portion of neural structures and remnants of dermal elements overlapping the rostral margin of the NP are associated with delayed occurrence of dermoid/ epidermoid cysts. Postoperative histopathological investigation of the resected specimens is recommended. Once dermal elements are revealed, repeated imaging examination and additional surgery should be considered.

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“…It occurs in two main forms, namely, open spina bifida (or spina bifida hole) and closed spina bifida (or spina bifida occulta). 5 The optimal time for the screening of the three types of NTDs (open spina bifida, anencephaly, and encephalocele) is during the second trimester (15 weeks-20 weeks 6 days). The risk that a pregnant women may be carrying an ONTD fetus is calculated using levels of AFP combined with the gestational age, last menstrual period, and maternal weight.…”

Section: Impact Statementmentioning

confidence: 99%

“…It occurs in two main forms, namely, open spina bifida (or spina bifida hole) and closed spina bifida (or spina bifida occulta). 5…”

Section: Introductionmentioning

confidence: 99%

Construction and predictive value of risk models of maternal serum alpha-fetoprotein variants and fetal open neural tube defects

Chen

Wang

Chen

et al. 2022

Exp Biol Med (Maywood)

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The correlation of maternal serum alpha-fetoprotein (AFP) variants (AFP-L2, AFP-L3), free beta-human chorionic gonadotropin (free β-hCG), and open neural tube defects (ONTDs) during the second trimester, and the screening efficiency of different risk models remain indistinct. We conducted a retrospective case-control study, and studied 57 pregnant women with ONTD fetuses and 569 pregnant women with normal fetuses. The receiver operating characteristic curve method indicated the best cutoff value and area under the curve (AUC). The predictive value of ONTD risk models by free β-hCG, AFP, AFP-L2, and AFP-L3 was investigated via integrated discrimination improvement (IDI), net reclassification improvement (NRI), and decision curve analysis (DCA). Compared to the control group, AFP, AFP-L2, and AFP-L3 levels were significantly higher, while free β-hCG level was significantly lower in the study group. The triple-index model of free β-hCG + AFP-L2 + AFP-L3 and the dual-index model of AFP-L2 + AFP-L3 showed the best predictive values, respectively (AUC = 0.905; AUC = 0.885). The order of the single-index model AUCs was AFP-L3 > AFP-L2 > AFP > free β-hCG. The negative predictive value, false positive rate, and negative likelihood ratio of AFP-L2, AFP-L3 alone, or combined with free β- hCG were better than those of AFP alone; however, the positive likelihood ratio was the opposite. The replacement of AFP by AFP-L2 or AFP-L3 combined with free β-hCG increased the IDI and NRI for predicting ONTD. The top five DCAs were AFP-L2 + free β-hCG, free β-hCG, AFP-L3, AFP + free β-hCG, and AFP. Indicators of maternal serum free β-hCG, AFP-L2, and AFP-L3 in the second trimester exhibited high sensitivity and specificity screening for ONTD fetuses. Risk models constructed using AFP-L2 + AFP-L3 and AFP-L2 + AFP-L3 + free β-hCG demonstrated better screening efficiency.

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Systematic Classification of Spina Bifida

Cited by 7 publications

References 39 publications

Determining Hydrocephalus and V-P Shunt Requirements After Repair of Myelomeningocele and Myeloschisis Defects in Infants

Determining Hydrocephalus and V-P Shunt Requirements After Repair of Myelomeningocele and Myeloschisis Defects in Infants

Histopathological presence of dermal elements in resected margins of neural structures obtained from initial repair surgery for myelomeningocele

Construction and predictive value of risk models of maternal serum alpha-fetoprotein variants and fetal open neural tube defects

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