08 January 2025

Doctors cured a newborn with a congenital spinal hernia

American physicians reported a successful case of management of a newborn patient with a severe congenital external soft-tissue protrusion of the spinal cord. The defect in the lumbosacral neural tube was detected by ultrasound at 20 weeks of gestation. During counseling, the parents refused intrauterine surgery, so cesarean delivery was scheduled for 39 weeks of gestation, given the absence of other complications. The newborn had good Apgar scores (nine points) at the first and fifth minutes after delivery. On objective examination after delivery, he was visually identified as having a fluid-filled red mass measuring 7.7 × 7.1 × 5.3 centimeters, protruding outward from a lumbosacral segment defect. The findings were confirmed by MRI. Doctors Tariq Parker and Kristopher Kahle of Massachusetts General Hospital shared the case in the New England Journal of Medicine.

Six days after birth, doctors excised the protrusion and reconstructed the defect; no nerve structures were found in it. This confirmed the diagnosis of a meningocele, an open neural tube defect in which the soft cerebral membrane and the cerebrospinal fluid in it (but not the nerve tissue) form a hernia through a defect in the spinal column. The hernia and defect were sutured, and the child was discharged home four days later. On examination at six months of age, his development was normal.

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