[LEJ8]

Has anyone adopted or considered adopting a child with this condition? The child I am considering has had surgery, but from what I've read, it is rare and there is not much out there on it.

[sak9645]

I'm not a doctor or other medical professional, but here is my understanding.

A lumbar meningocele is one form of spina bifida.

Spina bifida is not particularly rare. It occurs worldwide in about 1 to 2 out of every thousand births. Failure to have enough folic acid in the diet can increase the risk of having a baby with spina bifida, but there are other genetic and environmental causes as well. Simple lumbar meningoceles, however, are the least common form of spina bifida, although they are one of the milder forms of the problem.

Basically, spina bifida is a neural tube defect. The spinal cord may not form correctly during the earliest days of fetal development, and/or the part of the spine surrounding the spinal cord may not form correctly, so that part of the spinal cord is exposed.

The degree of disability that spina bifida causes varies with the location of the birth defect, and with its complexity. It is possible to have a simple meningocele, where parts of the vertebrae don't form right, and the meninges (membranes that enclose the central nervous system) protrude through them, forming a sac or cyst that contains cerebrospinal fluid. In such a case, the spinal cord and nerves may not be damaged, and there may be few functional problems if the sac is not damaged.

However, you have to be sure that this is what you are dealing with. You should get every bit of medical information that you can from China, and share it with a medical expert in a children's hospital.

In other cases of spina bifida, there can be significant damage to the spinal cord and nerves. Some people with spina bifida, for example, have paralysis of the lower limbs and/or lifelong incontinence of bladder and bowel. Some people with spina bifida also develop hydrocephalus, or the buildup of cerebrospinal fluid in the ventricles of the brain. In some cases, where the spinal cord becomes "tethered" to the spine, scoliosis, or extreme curvature of the spine, can result.

While nerve damage that has already occurred cannot be repaired, surgery is sometimes used to prevent damage or further damage. Pediatric neurosurgeons can sometimes place the spinal cord and root nerves back into the spine and can cover it with meninges, muscles, and skin. A shunt can be put into the head, if necessary, to allow cerebrospinal fluid to drain safely into the abdomen and pass out of the body.

Some people with damage to nerves affecting the legs and feet can walk with the assistance of braces, though some will be mobile only with a wheelchair. People with damage to the nerves affecting bladder function will need catheterization at intervals, over the course of a day. People with damage to nerves affecting bowel function can sometimes benefit from bowel training programs.

In short, I would suggest that you read as much about spina bifida as you can, and make sure that you understand the full extent of the waiting child's problem. Be sure to share all the information you have with a pediatric neurosurgeon. Only then can you decide if you will be able to parent the child.

Sharon