Expert consensus on diagnosis and treatment of spina bifida_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 Spina Bifida Group of Professional Rehabilitation Committee of Disabled Limbs & Trunk of China

Corresponding author：

Spina Bifida Group of Professional Rehabilitation Committee of Disabled Limbs & Trunk of China , Email: boxiu@scsurgery.com

Keywords：

Spina bifida; tethered spinal cord; expert consensus; diagnosis; treatment

DOI：

10.7507/1002-1892.202105099

Video：

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Abstract Full text Figures/Tables Video References Cited by

Spina bifida and tethered spinal cord are congenital diseases that can lead to severe disability. At present, most doctors in relevant specialties in China still have insufficient understanding of spina bifida, resulting in high incidence and aggravation of its complications. To provide guidance for the diagnosis and treatment of spina bifida and tethered spinal cord in China, experts from neurosurgery, urology, orthopedics, spine surgery, and rehabilitation departments who have experiences in the diagnosis and treatment of spina bifida discussed and summarized their experiences, and referred to the relevant literature on the diagnosis and treatment of spina bifida at home and abroad. Expert consensus was formed in the following aspects: concept, classification, and pathological changes of spina bifida; diagnosis; treatment process and operation timing; principles and methods of treatment; rehabilitation; and follow up. This expert consensus can provide reference for relevant care providers of spina bifida in China.

Citation： Spina Bifida Group of Professional Rehabilitation Committee of Disabled Limbs & Trunk of China . Expert consensus on diagnosis and treatment of spina bifida. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(11): 1361-1367. doi: 10.7507/1002-1892.202105099 Copy

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1. Molloy AM, Pangilinan F, Brody LC. Genetic risk factors for folate-responsive neural tube defects. Annu Rev Nutr, 2017, 37: 269-291.
2. Castill J, Castillo H, Brei TJ. Guidelines and scientifically-based spina bifida care: Guidance across the lifespan in a global health context. J Pediatr Rehabil Med, 2020, 13(4): 453-455.
3. Ryznychuk MO, Kryvchanska MI, Lastivka IV, et al. Incidence and risk factors of spina bifida in children. Wiad Lek, 2018, 71(2 pt 2): 339-344.
4. Atta CA, Fiest KM, Frolkis AD, et al. Global birth prevalence of spina bifida by folic acid fortification status: A systematic review and meta-analysis. Am J Public Health, 2016, 106(1): e24-e34.
5. D’Antoine H, Bower C. Folate status and neural tube defects in aboriginal Australians: the success of mandatory fortification in reducing a health disparity. Curr Dev Nutr, 2019, 3(8): nzz071. doi: 10.1093/cdn/nzz071.
6. 王欣业, 李采青, 王义成, 等. 神经管畸形发病率及相关预防措施的探讨. 河北医药, 2010, 32(21): 3058-3059.
7. Liu J, Xie J, Li Z, et al. Sex differences in the prevalence of neural tube defects and preventive effects of folic acid (FA) supplementation among five counties in northern China: results from a population-based birth defect surveillance programme. BMJ Open, 2018, 8 (11): e022565. doi: 10.1136/bmjopen-2018-022565.
8. Ye RW, Li S, Zheng JC, et al. Prevalence of neural tube defects at birth in 30 counties and cities of China, 1993-2000. 北京大学学报(医学版), 2002, 34(3): 204-209.
9. 臧建成. 号角吹响使命在肩——记中国残疾人康复协会肢体残疾康复专委会“脊柱裂学组”成立. 中国矫形外科杂志, 2019, 27(22): 2111-2112.
10. 修波. 应重视规范脊神经管畸形的分型. 中华医学杂志, 2017, 97(48): 3761-3762.
11. 修波. 实用脊神经管畸形分型及其临床意义. 中华神经外科疾病研究杂志, 2017, 16(5): 393-396.
12. Blount JP, Bowman R, Dias MS, et al. Neurosurgery guidelines for the care of people with spina bifida. J Pediatr Rehabil Med, 2020, 13(4): 467-477.
13. Beierwaltes P. Guidelines for the care of people with spina bifida. J Pediatr Nurs, 2019, 45: 81-82.
14. Spina Bifida Association. Guidelines for the care of people with spina bifida (2018)[S/OL]. [2021-08-10]. https://www.spinabifidaassociation.org/guidelines/.
15. 修波, 李萃萃, 萧凯, 等. 复杂性脊髓脂肪瘤的临床分型和手术治疗. 中华神经外科杂志, 2020, 36(11): 1110-1115.
16. Jones V, Wykes V, Cohen N, et al. The pathology of lumbosacral lipomas: macroscopic and microscopic disparity have implications for embryogenesis and mode of clinical deterioration. Histopathology, 2018, 72(7): 1136-1144.
17. Jones V, Thompson D. Placode rotation in transitional lumbosacral lipomas: are there implications for origin and mechanism of deterioration? Childs Nerv Syst, 2018, 34(8): 1557-1562.
18. 崔志强, 孙振兴, 萧凯, 等. 脊髓脊膜膨出合并脑积水手术方式的分析. 中华神经外科杂志, 2014, 30(2): 147-150.
19. 张春梅. 超声诊断胎儿脊柱裂的价值及鉴别诊断开放性脊柱裂和闭合性脊柱裂的实用效果分析. 系统医学, 2018, 3(1): 12-14.
20. 朱晨, 任芸芸, 严英榴, 等. 胎儿开放性脊柱裂和闭合性脊柱裂的超声鉴别诊断. 复旦学报 (医学版), 2016, 43(2): 195-200.
21. 杨培枝. 产前容积超声定位胎儿圆锥末端价值. 山西医药杂志, 2019, 48(4): 431-432.
22. 司丕成, 曾宪良, 刘福云, 等. 新生儿脊髓圆锥末端位置的B超研究. 临床小儿外科杂志, 2007, 6(1): 19-21.
23. 胡海云, 张蒂荣, 王玥, 等. 超声定位中晚孕期胎儿脊髓圆锥位置. 中国医学影像技术, 2013, 29(5): 779-782.
24. 修波. 脊柱裂研究进展. 中华神经外科疾病研究杂志, 2017, 16(2): 97-100.
25. 蔡明, 刘建民, 修波. 无症状儿童脊髓栓系早期预防性手术治疗研究. 中华神经外科疾病研究杂志, 2016, 15(1): 62-65.
26. Shang AJ, Yang CH, Cheng C, et al. Microsurgical efficacy in 326 children with tethered cord syndrome: a retrospective analysis. Neural Regen Res, 2019, 14(1): 149-155.
27. Morioka T, Murakami N, Shimogawa T, et al. Neurosurgical management and pathology of lumbosacral lipomas with tethered cord. Neuropathology, 2017, 37(5): 385-392.
28. Seki T, Hida K, Yano S, et al. Surgical outcomes of pediatric patients with asymptomatic tethered cord syndrome. Asian Spine J, 2018, 12(3): 551-555.
29. 萧凯, 孙振兴, 修波, 等. 婴幼儿脊髓脊膜膨出术后并发脑积水的影响因素及治疗方法分析. 中国微侵袭神经外科杂志, 2012, 17(9): 400-402.
30. 崔志强, 修波. 脊膜膨出术后并发良性颅内压增高23例临床分析. 北京医学, 2011, 33(5): 374-376.
31. Aufschnaiter K, Fellner F, Wurm G. Surgery in adult onset tethered cord syndrome (ATCS): review of literature on occasion of an exceptional case. Neurosurg Rev, 2008, 31(4): 371-383.
32. 修波, 李萃萃, 李文德, 等. 脊髓脂肪瘤的诊治策略. 中华神经医学杂志, 2020, 19(7): 725-728.
33. 修波, 李萃萃, 林和璞, 等. 显微外科手术治疗403例脂肪脊髓脊膜膨出疗效分析. 中华神经医学杂志, 2018, 17(7): 720-722.
34. Pang D. Surgical management of complex spinal cord lipomas: A new perspective. J Korean Neurosurg Soc, 2020, 63(3): 279-313.
35. Pang D. Surgical management of complex spinal cord lipomas: how, why, and when to operate. A review. J Neurosurg Pediatr, 2019, 23(5): 537-556.
36. Xiu Bo, Liu Fuyun, Shang Aijia, et al. Chinese expert consensus on diagnosis and management of split cord malformation. Journal of Neurorestoratology, 2020, 8(2): 83-92.
37. 修波. 脊髓纵裂诊治中的常见问题及其对策. 临床小儿外科杂志, 2019, 18(2): 83-87.
38. Joseph DB, Baum MA, Tanaka ST, et al. Urologic guidelines for the care and management of people with spina bifida. J Pediatr Rehabil Med, 2020, 13(4): 479-489.
39. 廖利民. 神经源性膀胱诊断治疗指南//那彦群, 叶章群, 孙光. 中国泌尿外科疾病诊断治疗指南. 北京: 人民卫生出版社, 2014: 370-409.
40. 侯艳. 脊髓损伤神经源性膀胱临床评估及治疗的研究进展. 中华老年骨科与康复电子杂志, 2019, 5(4): 238-244.
41. M受体拮抗剂临床应用专家共识编写组. M受体拮抗剂临床应用专家共识. 中华泌尿外科杂志, 2014, 35(2): 81-86.
42. Beierwaltes P, Church P, Gordon T, et al. Bowel function and care: Guidelines for the care of people with spina bifida. J Pediatr Rehabil Med, 2020, 13(4): 491-498.
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