Myelomenigocele

Myelomeningocele (MMC) represents a primary failure of neurulation and results in an exposed segment of spinal cord on the back of an infant; MMC is the most severe central nervous system (CNS) malformation compatible with life. Improved nutrition and periconceptional folate supplementation have significantly reduced the incidence of this disorder. Improved treatments, including valved shunt systems for hydrocephalus, surgical treatments for symptomatic Chiari malformations and spinal cord tethering, clean intermittent catheterization (CIC) of the neurogenic bladder, and orthopedic surgical procedures and external orthoses to improve ambulation and mobility, have greatly improved the outlook for these children; m any are entering adulthood, and transitional issues have consequently assumed significance.