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Symptoms vary widely depending on the severity of the defect. The primary symptoms of spina bifida are loss of sensation and movement in the legs and feet and poor bladder and bowel control due to nerve damage in the lower spine. As they grow, children may require braces or other assistance to walk and those with a severe defect may be wheelchair-bound.
Hydrocephalus or increased fluid in the brain is one common complication of myelodysplasia. Surgeons will usually insert a shunt--a thin plastic tube draining the brain cavities--to divert excess spinal fluid into other body cavities where it can be absorbed. Arnold Chiari Malformation, also occurs frequently in myelodysplasia patients. The brain becomes displaced into the upper spinal column, putting great pressure on the brain stem and causing symptoms such as vocal cord weakness, swallowing disturbances, arm weakness, and progressing leg spasticity. Surgical intervention aims to open up more space at the back of the head, to restore normal fluid circulation through the area, and to alleviate the pressure.
Orthopedic problems, including curvature of the back (scoliosis), hip dislocation, joint deformities, contracted muscles and weaker than normal bones, can be congenital or can occur gradually over time from the stress of spinal cord, nerve and muscular dysfunction.
Because of their lack of voluntary bladder control, children with myelomeningocele run a greater risk of kidney and bladder infections and, ultimately, of kidney damage. Urodynamic testing gives physicians better information on the best way to manage bladder and bowel function. Urologists at Children's Hospital have developed ways to quantitatively test nerve-related bladder function in children even before they can exert conscious control. This provides a powerful way to test the success of ongoing treatment, and to evaluate whether any deterioration in function is taking place. This test is frequently employed in evaluating whether or not a patient is suffering neurologic compromise.
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