PRAT 211:

SPINA BIFIDA MYELOMENINGOCELE

ASSESSMENT & TREATMENT:

*SAME AS MENINGOCELE* - Look at the Picture in “Acads Lang Muna”.

ADDITIONAL INFORMATIONS:
TREATMENT:
• Surgical Closure “Fetal Repair”
A. Pre-natal Surgery - Surgery before birth
B. Post-natal Surgery - Standard closure surgery, after birth.
• Assistive Devices
A. Walking with Braces, Crutches, or Walkers.
a) Reciprocating Gait Orthoses (Reference: POAT 311)
- 4-point gait (paired with reciprocal walker).
- The child must have retained hip flexion and hip adduction. The RGO
“mechanically translates hip extension on one side into hip flexion on the contralateral side.” The
device can be used for stability during walking and as a stander to allow arm movements for
functional activities.
- HKAFO with a chest strap.
- The orthotic hip joints are unlocked and are connected posteriorly by one or two
metal cables or a bar. Knees are stabilized with locks, and the feet are encased in solid ankle
orthoses.
- The cable(s) or bar prevent inadvertent hip flexion on the supporting leg.
Reciprocal four- or two-point gait is stable, because one foot is always on the floor. For sitting,
the wearer releases the cable(s) to enable both hips to flex.

B. Using wheelchairs.

Protect the exposed meninges in the spinal lesion.

Prevent infection.
Prevent trauma to exposed lesions.
Infant must be nursed prone and not dressed to prevent injury to the lesion.
Maintain skin integrity.

- SB Myelomeningocele pt. are Hydrocephalus d/t Shunts.

- They have bowel and bladder problems caused by Neural Tube Defect.
- They must be in SIDE-LYING POSITION to prevent pressure on the back lesion.