Lumbar spinal cord defect: How Hyderabad doctors saved life of 5DO infant

Yashoda hospital surgeons successfully performed surgery on a five-day-old baby with a lumbar spinal cord defect.

The baby came to the hospital with complaints of 5x5 cm swelling over the right gluteal region since birth. The baby, on the other hand, had been actively moving his limbs and had no cutaneous markers.

An MRI revealed a spinal defect involving the lumbar spinal cord, with cord tethering to soft tissue and meninges and neural elements (roots) herniating into the swelling. A lipomyelomeningocele was also discovered.

The doctors used nerve monitoring (iONM) to ensure that the defect's nerves were not damaged during handling. A Lipoma was discovered tying the cord and was excised. The wound was closed with absorbable sutures after the exposed herniated elements and thecal sac were repaired.

The doctors stated that the baby had no motor deficit in the lower limbs because she could move both lower limbs well. On POD-1, the baby developed urine retention, for which a catheter was placed. The catheter was removed for a trial period, but the baby was unable to pass urine on POD-4. Urology recommended a 2-week catheterization followed by an evaluation.

The baby was discharged with a catheter because the surgical wound was healing, and he could move both lower limbs. Later, the baby was evaluated at a local hospital and the catheter was removed, according to Dr. K. S. Kiran, Senior Neuro and Spine Surgeon, Yashoda Hospitals, Secunderabad.

In summary, a lipomyelomeningocele was operated on in a 6-day-old child with transient loss of bladder activity using iONM to reduce the risk of damage to neural structures. The child's bladder emptying has improved, and the wound is healing well.