Primary Neural Tube Defects in Pediatrics – A Focus on Lipomeningocele

Background: Lipomeningocele is a congenital abnormality of the neural tube. It affects approximately one in every 50,000 infants. This is one of the most uncommon varieties of Spina bifida, which happens when a neural tube does not shut completely and sticks out of the Spinal column, forming a sack beneath the skin. During embryonic development, about day 21 or week 3, neural folds fuse to form a neural tube and form a complete neural tube on the 28th day. The unfused part of the spinal cord leads to Spina bifida. Getting enough folic acid, during pregnancy can help to prevent neural tube defects. Mothers who are obese, have poorly controlled diabetes, and mothers who take certain anti-seizure medicines are at more risk of having a baby with a neural tube defect.

Case Presentation: A 6-month-old male child presented with the chief complaints of swelling in the sacral region since birth, non-progressive in size, and was not reducible. Magnetic resonance imaging of the lumbar spine revealed that there is Lipomeningocele at the sacral region and low insertion of the spinal cord with tethering.
Discussion: The primary objective is to reduce the stretching or straining of the spinal cord that occurs as the child grows. Prompt surgical interventions are crucial for the prevention of neurological deterioration.

Conclusion: A neurosurgeon works to "untether" the spinal cord, separating the spinal cord from the back tissues. The idea is to reduce the stretching or straining of the spinal cord that occurs as the child grows.