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What Does A White Bubble Between The Spinal Cord Indicate?
Question: Dear Doctor,
My 8 months old baby was born with lipomyelomenlingocele. After a week she had an operation to rectify the issue. Two months later she started to have constipation, which the pediatrician recommended the use of a laxative called "Mikrolax". Still at the age of 7 months she was still not going on her own and was depending solely on the laxative (also we noticed that the laxative was not fully effective). We decided to bring her to a Neonatal surgeon to check for any bowel problems. She ran some tests and suggesting manual dilatation using finger.
This brings me to the point of my question. After taking an MRI we noticed that in between my baby's spinal cord there is somewhat of a white bubble. The doctors report says its syringohydromyelia in the L4-L5 (diameter is 5mm).. Please can you elaborate a bit more on this and try to advise us what is the best solution to resolve this and whether this could be the reason why our baby is constipated? What are the success rate of treatments? What are the implications?
Thanks a lot for your expertise,
XXXX
My 8 months old baby was born with lipomyelomenlingocele. After a week she had an operation to rectify the issue. Two months later she started to have constipation, which the pediatrician recommended the use of a laxative called "Mikrolax". Still at the age of 7 months she was still not going on her own and was depending solely on the laxative (also we noticed that the laxative was not fully effective). We decided to bring her to a Neonatal surgeon to check for any bowel problems. She ran some tests and suggesting manual dilatation using finger.
This brings me to the point of my question. After taking an MRI we noticed that in between my baby's spinal cord there is somewhat of a white bubble. The doctors report says its syringohydromyelia in the L4-L5 (diameter is 5mm).. Please can you elaborate a bit more on this and try to advise us what is the best solution to resolve this and whether this could be the reason why our baby is constipated? What are the success rate of treatments? What are the implications?
Thanks a lot for your expertise,
XXXX
Brief Answer:
Double catheter rectal washes will be helpful
Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day
Dear XXXX
The MRI scan provided by you definitely shows dilattion of central canal of spinal cord known as Syringohydromyelia. This may sometimes cause affection of nerves supplying the bowel and bladder and may cause impacted stools.
Babies operated usually have neurological bowel and bladder, they may present with
1. Impacted stools with Psuedo-incontinence
2. Incontinence
In case of your baby it has developed into impacted stools. Giving only Microlax Laxative enema will not suffice. It includes variety of approaches.
I would suggest you the following
1. Diet modification: Include high fibre diet, avoid food stuffs containing refined wheat flour like bread , biscuits
2. Rectal washes: Rectal washes given using red rubber catheter No 8( Double catheter) washes is very effective in evacuation of stools. 2 red rubber catheter inserted into rectum, through one instilling glycerine followed by noraml saline, retaining it for 10-15 minutes . Through one catheter fluid goes in and through other catheter the liquified stools come out. I would suggest you to discuss it with your Surgeon and can plan things accordingly.
3. Rectal dilatation should be attempted by experienced surgeon, overzelous dilatation may cause incontinence
In case you need any further assistance, will be glad to assist you.
Take Care
best Regards
Dr Deepak Kishore
MBBS,MS,MCH
Consultant Pediatric & Neonatal Surgeon
Double catheter rectal washes will be helpful
Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day
Dear XXXX
The MRI scan provided by you definitely shows dilattion of central canal of spinal cord known as Syringohydromyelia. This may sometimes cause affection of nerves supplying the bowel and bladder and may cause impacted stools.
Babies operated usually have neurological bowel and bladder, they may present with
1. Impacted stools with Psuedo-incontinence
2. Incontinence
In case of your baby it has developed into impacted stools. Giving only Microlax Laxative enema will not suffice. It includes variety of approaches.
I would suggest you the following
1. Diet modification: Include high fibre diet, avoid food stuffs containing refined wheat flour like bread , biscuits
2. Rectal washes: Rectal washes given using red rubber catheter No 8( Double catheter) washes is very effective in evacuation of stools. 2 red rubber catheter inserted into rectum, through one instilling glycerine followed by noraml saline, retaining it for 10-15 minutes . Through one catheter fluid goes in and through other catheter the liquified stools come out. I would suggest you to discuss it with your Surgeon and can plan things accordingly.
3. Rectal dilatation should be attempted by experienced surgeon, overzelous dilatation may cause incontinence
In case you need any further assistance, will be glad to assist you.
Take Care
best Regards
Dr Deepak Kishore
MBBS,MS,MCH
Consultant Pediatric & Neonatal Surgeon
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for your prompt response doctor. I also wanted to find out more about the procedure to remove the Syringohydromyelia. What treatment methods are available for Syringohydromyelia? Which do you think would be the most suitable for this type and my baby? What are its short/long term implications? How will this affect my baby's life? What are your recommendations?
Thanks.
Thanks.
Brief Answer:
It's unlikely to progress
Detailed Answer:
Hi
Greetings
Syringohydromyelia does not require any specific treatment. Any further Surgical intervention would only be required when there is deterioration of neurological function like development of weakness in lower limb or bowel/bladder incontinence. Even in such presentation the cause has to be attributable to tethered cord syndrome ( cord getting deformed and pulled by fibrous tissue).
In majority of cases it's unlikely to progress further.
As there is no tethering of the cord and there is no incontinence the overall prognosis is good.
Do get back for any further assistance.
Wishing you and your family a very happy and healthy life.
Take care
Best Regards
Deepak
It's unlikely to progress
Detailed Answer:
Hi
Greetings
Syringohydromyelia does not require any specific treatment. Any further Surgical intervention would only be required when there is deterioration of neurological function like development of weakness in lower limb or bowel/bladder incontinence. Even in such presentation the cause has to be attributable to tethered cord syndrome ( cord getting deformed and pulled by fibrous tissue).
In majority of cases it's unlikely to progress further.
As there is no tethering of the cord and there is no incontinence the overall prognosis is good.
Do get back for any further assistance.
Wishing you and your family a very happy and healthy life.
Take care
Best Regards
Deepak
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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