1, the baby was born with a lumbar midline mass is what causes this may be a baby called – “spina bifida” congenital disease, the incidence of about 2/1000. The obvious spina bifida masses are divided into spinal cord spondylolisthesis, fatty spinal cord spondylolisthesis, spinal cord cystic protrusion and spondylolisthesis according to the different contents of the tissue; some of the masses are covered by a thin cystic wall without skin. Some of the masses had abnormal skin covering the surface, which was cyanotic, or had a purplish-red granulomatous surface. In cryptogenic spina bifida, there is no obvious mass, and depending on the type of pathology, it often manifests as longitudinal spina bifida, end filament traction, intradural lipoma, dorsal subcutaneous sinus tract, dermatomal cyst, spinal cord cleft syndrome, hydrocele, and caudal degeneration syndrome. 2, which low back manifestations suggest occult spina bifida hints suggest occult spina bifida lumbar back midline vascular malformation, hairy, hyperpigmentation (skin color is very thick, or brown, or black, or red), small concave or sinus tract (pressure with mucus or bean-like secretions squeezed out), skin redundancy or hip cleft asymmetry, foot inversion or valgus deformity, etc.. Most of the above suggests that there may be occult spina bifida, resulting in spinal cord traction with age, causing spinal cord tethering syndrome. 3, spina bifida baby if not treated in a timely manner will have what kind of impact on the child spina bifida baby if not treated in a timely manner can appear the following symptoms, seriously affect the baby’s future daily life: ① urinary and fecal dysfunction: common manifestations of urinary incontinence, frequent urination, urinary difficulties and urinary retention; stool constipation, constipation, or incontinence; ② sensory disorders of the lower limbs: manifestations of the lower limbs, perineum and low back sensory abnormalities and (3) Motor disorders of lower limbs: abnormal walking, weakness, deformation and pain of lower limbs, neurogenic ulcers, and scoliosis may also be combined; (4) Erectile dysfunction of the penis. At the same time, the above-mentioned symptoms gradually worsen with age and continue until the adult tends to stabilize. Eventually, the disease can cause upper urinary tract damage, hydronephrosis and renal failure, which are the main causes of death. Before the 1970s, the quality of life of these children was poor, with the incidence of upper urinary tract damage reaching 50% to 90% before the age of 10, and the overall mortality rate reaching 50%. With advances in treatment technology, the survival rate and quality of life have improved significantly, but long-term treatment and follow-up are still needed. 4, how to diagnose and treat spina bifida Baby spina bifida requires multidisciplinary collaboration between urology, neurosurgery and rehabilitation departments for diagnosis and treatment. Diagnosis includes MRI, urodynamics and neuromuscular examinations to assess the degree and type of neuropathy and the dysfunction it causes in the bladder and lower extremities. Treatment includes ① treatment of primary disease; ② treatment of bladder urethral dysfunction: specialist treatment in urology for pre-existing or follow-up bladder dysfunction to achieve bladder capable of low-pressure urine storage with large bladder capacity, no incontinence, no infection and no impairment of upper urinary tract function; control of residual urine volume below 10%-20% of bladder capacity. ③Rehabilitation: After the above treatment, you need to visit the hospital every year for follow-up assessment and insist on comprehensive, continuous and complete rehabilitation training. 5, spina bifida baby why must long-term continuous urodynamic examination Urodynamics is based on the basic principles and methods of fluid mechanics and electrophysiology, detection of pressure, flow rate and bioelectrical activity in various parts of the urinary tract, so as to understand the function and mechanism of urinary tract delivery of urine, as well as the pathophysiological changes of voiding dysfunctional diseases. Long-term continuous urodynamic evaluation of spina bifida babies is necessary because: (1) the first symptom of neuropathy in spina bifida babies is vesicourethral dysfunction, and urodynamic testing is the “gold standard” for assessing the type and severity of vesicourethral dysfunction. The main cause of death in spina bifida babies is upper urinary tract damage due to bladder dysfunction. Urodynamic testing can effectively predict the risk of upper urinary tract damage so that timely methods can be used to prevent it. (iii) Only 5-10% of babies develop upper urinary tract damage due to bladder dysfunction at birth, and the incidence rises to 63% in childhood and higher in adults. Therefore, even if babies are asymptomatic, they may develop neurological damage as they develop, leading to bladder dysfunction and causing upper urinary tract damage. This requires that our babies must undergo annual urodynamic examinations until adulthood in order to detect bladder dysfunction in a timely manner and give early treatment, thus effectively preventing the occurrence of upper urinary tract damage. 6, whether there is a risk of urodynamic examination The urodynamic examination process is mainly first placed in the bladder via the urethra with a very thin special double-lumen pressure measuring tube, and at the same time a rectal pressure measuring tube is placed in the rectum to simulate bladder filling and urination, to detect the pressure changes in the bladder urethra and other conditions throughout the process. Pediatric urodynamic testing is difficult, with special equipment requirements, and a physician with extensive experience must perform the procedure and analyze the results. The Pediatric Urodynamics Center of the First Affiliated Hospital of Zhengzhou University, founded in 2001, is a nationally renowned pediatric urodynamics center with examination techniques that have reached an internationally advanced level. It has successfully performed urodynamic examinations for more than 4,000 patients with bladder dysfunction. Occasional discomfort in urination is seen after urodynamic examination, and the symptoms usually disappear after 1-2 days of drinking more water. As long as you follow the doctor’s instructions, your baby can have a safe and successful urodynamic test. 8.What do you need to do before the urodynamic test for your baby? The following preparations are needed before the test: ① make an appointment with the examiner (appointment number: 037166913286); ② empty the stool before the test, if there is dry stool apply corkage or clean enema; ③ the child should drink an appropriate amount of water to hold the urine; ④ no restriction on diet, the child should eat an appropriate amount of food; ⑤ bring the previous test data for for analysis of the results. The child should drink plenty of fluids and be given prophylactic antibiotics if necessary. Although spina bifida cannot be completely cured, we believe that through the joint efforts of parents and health care professionals, your baby can still be as smart and cute as normal, grow up healthy and live a normal life. We would like to remind you to ① go to a regular (urodynamic test) hospital to avoid serious consequences; ② before the surgical treatment, pay attention to avoid dragging and pulling when turning your baby to prevent some of the pouches from getting infected due to friction and rupture. ③After surgical treatment, regardless of whether the baby has the clinical symptoms mentioned above, follow-up evaluation and long-term rehabilitation must be carried out every year until the baby becomes an adult, and only then can we relax our vigilance.