. Röntgen ray diagnosis and therapy . Fig. 87.—Spina Bifida (See Fig. 88). the cyst wall cannot be arrested unless immediate and extensiveremoval is undertaken. On the other hand, myelomeningocele and myelocystocele offera less favourable prospect. In these cases the injection treat- 135 ment is always a failure. I J in myelomeningocele the nerves arefreely dispersed in the sac, the area medullaris vasculosa, afterbeing circumcised, must be reduced into the vertebral canal, andthe union of the soft tissues above must be reduced in the same. -Spina Bifida, illustrated by Fig. 87, in An
. Röntgen ray diagnosis and therapy . Fig. 87.—Spina Bifida (See Fig. 88). the cyst wall cannot be arrested unless immediate and extensiveremoval is undertaken. On the other hand, myelomeningocele and myelocystocele offera less favourable prospect. In these cases the injection treat- 135 ment is always a failure. I J in myelomeningocele the nerves arefreely dispersed in the sac, the area medullaris vasculosa, afterbeing circumcised, must be reduced into the vertebral canal, andthe union of the soft tissues above must be reduced in the same. -Spina Bifida, illustrated by Fig. 87, in Anteroposterior Pro-jection. way. If situated in the lumbo-sacral region, the preservation ofthe nerve strings is of but little importance. In myelocystocele the reposition should be made in the samemanner. If there be any opening in the bone, protection should be 136 THE KONTGEN EAYS sought by covering it with a strong flap, consisting of integumentand muscle. One of the greatest difficulties encountered in the treatmentof spina bifida is that its various types cannot, as a rule, be de-fined before operation. Between meningocele and myelocystocele,indeed, distinction is often quite impossible. Sometimes conclu-sions may be drawn if an opening of the bone can be palpated, or
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