1st order
- Spina bifida aperta: here, the cele (blister-like protrusion; hernial sac) is first incised (sparing the nervous tissue). The spinal cord is gently transferred back into the spinal canal. The spinal canal is closed with a fascial flap. Wound closure is performed in layers or by means of plastic coverage.
- Myelomeningocele: here, the closure must be done immediately after birth due to the increased risk of infection of the spinal cord.
- Hydrocephalus (hydrocephalus): here, a “shunt” must be created to relieve the pressure, that is, a catheter is inserted to drain the cerebrospinal fluid (brain fluid) into the abdomen (abdominal cavity).
In the case of co-existing micturition disorders (bladder emptying disorders; neurogenic bladder), the following surgical measures can be considered:
- In cases of uncontrollable detrusor hypertrophy (trabeculation and pseudodiverticulum formation of the bladder):
- Denervation (separation of the detrusor from the associated nerve tracts) of the bladder.
- Bladder augmentation (bladder enlargement).
- Rhizotomy – surgical transection of a nerve root.
- For unmanageable sphincter externus spasticity:
- Incision (cutting into) the sphincter externus.
- Stent implantation (small, lattice-shaped support that serves to dilate) to widen the sphincter externus (external sphincter)
- Injection of botulinus toxin into the sphincter.
The required surgical procedures should be completed before enrollment.