Natural History (Myelomeningocele)
Natural history of a large lumbosacral myelomeningocele of an infant who is now in the third trimenon. The cele has not been operated in the neonatal period due to the high level of neurological involvement (L2 or higher). This type of proceeding is called selection for non-treatment; nevertheless, the patient survived.
The lumbosacral myelomeningocele is completely epithelialized, but the cele is very prominent because of the missing closure of the dura, of the muscles of the back, of the external layer by normal skin, and because of the increased cerebrospinal fluid pressure in the spinal subarachnoid space.
The mass is very painful and hinders personal hygiene. $$turu_13??nr=2££The alternate figure 1§§ illustrates the start of the sponaneous course of the disease (natural history), if no surgery is performed. Many spina bifida children are very robust and do not die spontaneously.
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