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Neurosurgery is one of many specialties required to treat children with spina bifida. The initial closure of the spinal column, performed by a neurosurgeon, is essential, but only the beginning of treatment. The team of specialists who participate in the Myelodysplasia Program at Children's Hospital includes pediatricians, geneticists, neurosurgeons, orthopedic surgeons, urologists, physical therapists, social workers, neurologists, nutritionists and psychologists.
Care is aimed at improving the child's musculoskeletal functioning and promoting independent living. It can include surgical intervention, braces and supports, corrective casts, therapy to improve physical strength and coordination, and strategies for improving mobility, bladder and bowel functioning and coping with social situations.
When spina bifida is diagnosed pre-natally (before birth) some medical centers are performing intrauterine surgery to close the defect early in the pregnancy. This approach seemed promising when first proposed (amniotic fluid is toxic to the exposed nerves), but early results have not shown a clear benefit to pre-natal surgery with respect to restoration or improvement of function in the legs. It may be beneficial in preventing the development of hydrocephalus and symptoms related to the Chiari II malformation.
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