With over 20 years of expertise, Dr Uday Andar is the best Paediatric Neurologist in Mumbai. Spinal Dysraphism, Craniofacial Anomalies, Congenital Scoliosis, and Micro Neurosurgery operations are among his specialities. He has previously worked as a consultant at Lilavati Hospital and Bombay Hospital in Mumbai. He is now working at the SRCC Children's Hospital in Mumbai.
He completed his MBBS (1980) and MCh (1985) degrees in General Surgery from Mumbai's TN Medical College. Later, he earned a master's degree ( MS ) in neurosurgery from the prestigious University of Bombay. Dr Andar holds membership of The Indian Medical Association of Neurological Society of India and the International Society of Pediatric Neurosurgery and is a member of the Indian Journal of Pediatric Neurosurgery. He is also an advisor for research in YP2D Lifescience, India. He has been the guest professor at several scientific meetings, at CMEs and conferences internationally, and has been invited to lecture about several neurological conditions in children. There are also several national and international publications in his name.
What is Spinal dysraphism?
Spinal dysraphism (Spinal = to do with the spine, Dysraphism = incomplete fusion)is a disorder in which the spine and spinal cord of a baby do not develop normally during pregnancy. The spine and spinal cords are then exposed to the external or internal environment. The term "spinal dysraphism" refers to both visible and unseen imperfect structures in the spine. On the surface of certain newborns' skin, incomplete formation may be seen. In other cases, the partial development is not visible beneath the skin.
The following are some of the conditions that are classified as spinal dysraphism:
- The spinal cord is not contained within the spinal column and protrudes outside the body in a sac, known as myelomeningocele or open spina bifida.
- When one or more vertebrae (bones in the spine) are deformed (not formed correctly) and a layer of skin covers the opening in the vertebrae, it is known as spina bifida occulta.
- Benign tumours or cysts – these are noncancerous tumours but can cause additional pressure on the spinal cord
- Lipomyelomingocele is a condition in which fat grows abnormally around the spinal cord and its surrounding region. This disease may not necessarily create symptoms right immediately, but it can progress to bladder and bowel difficulties. UTIs regularly, as well as leg and back discomfort
Cause
Although the specific cause of spinal dysraphism is unknown, certain genetic and environmental variables are likely to be involved. Many kinds of spinal dysraphism arise during the early phases of foetal development when the spinal cord is still developing. Folic acid deficiencies are considered to contribute to or enhance the chance of developing certain diseases. It can be noticed at various points depending on the severity of the disease. Myelomeningocele, often known as open spina bifida, is frequently diagnosed before or shortly after birth. Other diseases, such as benign tumours or spina bifida occulta, might lie undetected for a long time before symptoms emerge.
Treatment
Treatment depends on the type of spinal dysraphism your baby has and if they have other medical conditions. If your infant has myelomeningocele, a provider will examine the spinal dysraphism shortly after birth and cover it with a soft dressing (bandage). Myelomeningocele infants usually receive surgery within 72 hours ( 3 days ) of birth. Following surgery, your baby will be evaluated by the care team, who will provide recommendations for future care. The Fetal Care programme coordinator will make sure your baby receives adequate follow-up care in the future. This involves connecting your infant with specialists and scheduling follow-up appointments with the relevant doctors.
Decompression surgery, the most frequent treatment for diastematomyelia, involves removing the small piece of bone or cartilage that splits the spinal cord. The spinal cord has greater space within the spinal column once this portion is removed. Removing this portion often “un-tethers” the spinal cord, enabling it to move freely once again. The dura, the sleeve that surrounds the spinal cord, is sometimes repaired at the same time as the spinal cord.
Microsurgical resection can be used to remove tumours and cysts from the spinal cord. The removal of masses from the spinal cord is done using an operating microscope and very tiny instruments.
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