Patient's question:
11 years old, occasionally enuresis at night. One week ago, an X-ray at Harbin Children's Hospital revealed a spinal dysraphism of the first to fourth sacral vertebrae. Currently, he walks with an in-toeing gait. He suddenly experienced lower limb weakness and inability to walk in August, which resolved after one day.Doctor's answer:
Congenital hidden spinal dysraphism is a gap in the lumbar-sacral vertebrae, where the cauda equina nerves within the vertebral canal, along with the dura mater, protrude, adhere, and become fixed through the gap. When symptoms such as urinary frequency, urgency, incontinence, constipation, fecal incontinence, calf muscle atrophy, high arch feet, equinovarus foot, or even lower limb paralysis occur due to traction, tension, ischemia, and the development of sacral spinal cord wandering nerve centers and cauda equina nerve symptoms, surgery is required to separate the adhesions, cut the filum terminale, release the cauda equina, and restore sacral spinal cord blood supply. If the condition is mild, such as only enuresis, conservative treatment may be sufficient, and no immediate treatment is necessary. If the condition is severe, such as with urinary and fecal incontinence, surgical treatment is definitely required, and the earlier the surgery, the better the outcome. You can consult a pediatric neurosurgery department.