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253: SPINA BIFIDA

Kay Tasso, PhD, PT, PCS

CONDITION/DISORDER SYNONYMS

  • Meningocele

  • Meningomyelocele

  • Myelocele

  • Myelodysplasia

  • Myelomeningocele

  • Spina bifida aperta

  • Spina bifida cystica

  • Spina bifida occulta

  • Spinal dysraphism

ICD-9-CM CODES

  • 741 Spina bifida

  • 741.0 Spina bifida with hydrocephalus

  • 741.00 Spina bifida unspecified region with hydrocephalus

  • 741.01 Spina bifida cervical region with hydrocephalus

  • 741.02 Spina bifida dorsal (thoracic) region with hydrocephalus

  • 741.03 Spina bifida lumbar region with hydrocephalus

  • 741.9 Spina bifida without mention of hydrocephalus

  • 741.90 Spina bifida unspecified region without hydrocephalus

  • 741.91 Spina bifida cervical region without hydrocephalus

  • 741.92 Spina bifida dorsal (thoracic) region without hydrocephalus

  • 741.93 Spina bifida lumbar region without hydrocephalus

  • 742.0 Encephalocele

ICD-10-CM CODES

  • Q01 Encephalocele

  • Q01.0 Frontal encephalocele

  • Q01.1 Nasofrontal encephalocele

  • Q01.2 Occipital encephalocele

  • Q01.8 Encephalocele of other sites

  • Q05 Spina bifida

  • Q01.9 Encephalocele, unspecified

  • Q05.0 Cervical spina bifida with hydrocephalus

  • Q05.1 Thoracic spina bifida with hydrocephalus

  • Q05.2 Lumbar spina bifida with hydrocephalus

  • Q05.3 Sacral spina bifida with hydrocephalus

  • Q05.4 Unspecified spina bifida with hydrocephalus

  • Q05.5 Cervical spina bifida without hydrocephalus

  • Q05.6 Thoracic spina bifida without hydrocephalus

  • Q05.7 Lumbar spina bifida without hydrocephalus

  • Q05.8 Sacral spina bifida without hydrocephalus

  • Q05.9 Spina bifida, unspecified

  • Q07.01 Arnold–Chiari malformation

  • Q07.3 Arnold–Chiari syndrome with spina bifida and hydrocephalus

  • Q76.0 Spina bifida occulta

FIGURE 253-1

A large, wide tuft of thick terminal hair on the lumbosacral spine noted at birth. She had underlying tethered cord (note midline scar due to surgical repair). (From Goldsmith LA, Katz SI, Gilchrest BA, Paller A, Leffell DJ, Wolff K, eds. Fitzpatrick’s Dermatology in General Medicine. 8th ed. http://www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

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PREFERRED PRACTICE PATTERN

  • 5C: Impaired Motor Function and Sensory Integrity Associated With Nonprogressive Disorders of the Central Nervous System—congenital origin or acquired in infancy or childhood

PATIENT PRESENTATION

A 6-year-old female child with a diagnosis of spina bifida at L2-L3 is referred to physical therapy for evaluation and treatment. The mother reports not being aware of her pregnancy until 9 weeks gestation. At 14 weeks, a fetal ultrasound indicated the presence of myelomeningocele. As a result, the infant was delivered via C-section to prevent rupture of the lumbosacral sac. The infant had surgery to close the sac within 24 hours after birth and placement of a ventroperitoneal shunt within 72 hours after birth. The child received physical therapy as an infant and young child and currently receives services through the public school system. The family requested outpatient physical therapy now to teach the patient how to transfer herself independently as she has grown too large for the mother to transfer her by herself.

KEY FEATURES

Description

  • Group of disorders involving failure of closure (split spine) in the caudal end of the spinal column in utero...

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