Myelomenigocele

Myelomeningocele is the most severe form of spina bifida, a type of neural tube defect (NTD) where the spinal cord and meninges protrude through an opening in the baby’s back, typically along the lower spine. It develops during the first month of pregnancy, often before a woman even knows she is pregnant. In Bangladesh, a significant number of infants are born each year with untreated or late-diagnosed myelomeningocele, largely due to a lack of prenatal screening, nutritional awareness, and access to specialized surgical care. With timely neurosurgical intervention and long-term support, many of these children can lead productive lives. 🔬 Causes and Risk Factors Myelomeningocele occurs due to incomplete closure of the neural tube during early fetal development. Contributing risk factors include: Folic acid deficiency during pregnancy Maternal diabetes or obesity Exposure to certain medications or toxins Family history of neural tube defects Low awareness and poor antenatal care in rural areas of Bangladesh Despite its preventability, many families are unaware of folic acid supplementation, leading to a higher incidence of myelomeningocele in underserved communities. 🧒 Symptoms of Myelomeningocele The severity of symptoms depends on the location and extent of the spinal defect, but common signs include: 1.Visible sac on the back containing spinal cord tissue 2.Partial or complete paralysis of the lower limbs 3.Loss of bladder and bowel control 4.Hydrocephalus (fluid accumulation in the brain) 5.Orthopedic deformities like clubfoot or scoliosis 6.Cognitive or developmental delays (in severe cases) In Bangladesh, many children with this condition present late to hospitals due to financial barriers and lack of transportation to specialized centers like NINS. 🧪 Diagnosis Prenatal Diagnosis: Ultrasound at 18–22 weeks can detect open neural tube defects Maternal serum alpha-fetoprotein (MSAFP) testing Fetal MRI for detailed assessment (less available in Bangladesh) Postnatal Diagnosis: Physical examination of the spinal lesion MRI or CT scan to assess the spinal cord Ultrasound of the brain to detect hydrocephalus Urodynamic studies to assess bladder function Dr. Nafaur emphasizes early imaging and multidisciplinary evaluation for every diagnosed case. 🛠️ Surgical Treatment of Myelomeningocele Surgery is the first critical step in managing myelomeningocele. The goal is to: Close the open spinal cord and skin defect Prevent infection, especially meningitis Preserve whatever neurological function remains Reduce future complications 🏥 Common Surgical Procedures: ✅ Early Surgical Closure (within 48–72 hours) Prevents infection and preserves neural tissue Dr. Nafaur performs this delicate microsurgery at NINS with expert care ✅ VP Shunt Placement For children with hydrocephalus, ventriculoperitoneal shunt is placed to drain excess cerebrospinal fluid ✅ Orthopedic and Urological Surgeries Managed in collaboration with physiatrists and pediatric urologists "Timely closure of the myelomeningocele and appropriate follow-up can dramatically improve a child’s lifespan and quality of life." — Dr. Md. Nafaur Rahman 🧠 Postoperative Care and Rehabilitation Post-surgical management includes: Antibiotics and wound care Monitoring for shunt infection or malfunction Bladder and bowel training Physical therapy to improve mobility Orthotic support and management of foot deformities Parental counseling and home care training At the Bangladesh Paediatric Neurocare Centre, Dr. Nafaur and his team provide multidisciplinary care designed to empower families. 🌟 Prognosis and Long-Term Outcomes While myelomeningocele is a lifelong condition, early intervention and comprehensive care can significantly improve outcomes: Many children walk with braces or walkers Some may have normal intelligence, others may need special education Proper bladder management helps prevent kidney damage Vocational training helps many become independent adults In Bangladesh, long-term success depends on access to care, public health awareness, and family support systems. Challenges in Bangladesh – Why Awareness Matters Lack of prenatal care and folic acid education High out-of-pocket healthcare costs for surgery and rehab Shortage of specialized pediatric neurosurgeons Inadequate follow-up and rehabilitation in rural regions Social stigma and misinformation among families Dr. Nafaur is actively involved in awareness campaigns, public seminars, and training programs to improve outcomes for spina bifida in Bangladesh. 👨‍⚕️ Why Choose Dr. Md. Nafaur Rahman? 🎓 Fellowship-trained Pediatric Neurosurgeon 🏥 Assistant Professor at the National Institute of Neurosciences (NINS) 👶 Extensive experience in neonatal neural tube defect repair 💼 Proven record in multidisciplinary care for spina bifida patients 💬 Provides family-friendly counseling, transparent cost plans, and follow-up 📍Available at NINS and Bangladesh Paediatric Neurocare Centre 📞 Contact for Myelomeningocele Surgery and Treatment in Bangladesh Dr. Md. Nafaur Rahman Assistant Professor, Pediatric Neurosurgery, NINS Chief Consultant, Bangladesh Paediatric Neurocare Centre 📱 For Serial/Appointment: 01912988182 | 01607033535 🌐 Visit: www.neurosurgeonnafaur.com