{"id":413,"date":"2025-11-12T15:44:17","date_gmt":"2025-11-12T14:44:17","guid":{"rendered":"https:\/\/www.chu-tours.fr\/neurochirurgie\/?page_id=413"},"modified":"2025-11-13T13:07:02","modified_gmt":"2025-11-13T12:07:02","slug":"le-spina-bifida","status":"publish","type":"page","link":"https:\/\/www.chu-tours.fr\/neurochirurgie\/service-de-neurochirurgie-pediatrique\/le-spina-bifida\/","title":{"rendered":"Le Spina Bifida"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"413\" class=\"elementor elementor-413\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3409196 e-con-full e-flex e-con e-parent\" data-id=\"3409196\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-9ed761e elementor-widget elementor-widget-global elementor-global-220 elementor-widget-html\" data-id=\"9ed761e\" data-element_type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<!-- FIL D\u2019ARIANE DYNAMIQUE - CHRU TOURS (VERSION JAVASCRIPT\/CHEVRONS) -->\r\n<div id=\"breadcrumb-js\" class=\"breadcrumb\"><\/div>\r\n\r\n<style>\r\n    .breadcrumb {\r\n        font-size: 14px;\r\n        font-family: \"Segoe UI\", sans-serif;\r\n        margin-bottom: 20px;\r\n        color: #555;\r\n        display: flex;\r\n        flex-wrap: wrap;\r\n        gap: 0.5em;\r\n        align-items: center;\r\n        background: #f4f6f8;       \/* fond gris clair (modifiable ou \u00e0 supprimer) *\/\r\n        padding: 8px 12px;\r\n        border-radius: 4px;\r\n    }\r\n\r\n    .breadcrumb a {\r\n        text-decoration: none;\r\n        color: #008c9e;            \/* couleur des liens cliquables *\/\r\n        font-weight: 600;\r\n        text-transform: capitalize;\r\n    }\r\n\r\n    .breadcrumb span {\r\n        color: #0d3182;            \/* couleur du dernier \u00e9l\u00e9ment (page active) *\/\r\n        font-weight: 600;\r\n        text-transform: capitalize;\r\n    }\r\n\r\n    .breadcrumb .separator {\r\n        font-weight: normal;\r\n        color: #888;\r\n        margin: 0 4px;\r\n    }\r\n<\/style>\r\n\r\n<script>\r\n    document.addEventListener(\"DOMContentLoaded\", function () {\r\n        const path = window.location.pathname.split(\"\/\").filter(p => p);\r\n        if (path.length === 0) return;\r\n\r\n        let html = '';\r\n        let fullPath = \"\";\r\n\r\n        path.forEach((segment, index) => {\r\n            fullPath += \"\/\" + segment;\r\n            const label = decodeURIComponent(segment.replace(\/[-_]\/g, \" \"))\r\n            .toLowerCase()\r\n            .replace(\/^\\w\/, c => c.toUpperCase());\r\n\r\n            if (index < path.length - 1) {\r\n                html += `<span class=\"separator\">\u203a<\/span><a href=\"${fullPath}\">${label}<\/a>`;\r\n            } else {\r\n                html += `<span class=\"separator\">\u203a<\/span><span>${label}<\/span>`;\r\n            }\r\n        });\r\n\r\n        const container = document.getElementById(\"breadcrumb-js\");\r\n        if (container) container.innerHTML = html;\r\n    });\r\n\r\n    \/*\r\n\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\r\n\ud83c\udfa8 ASTUCES DE PERSONNALISATION (\u00e0 modifier au besoin)\r\n\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\r\n\r\n1. Modifier la couleur du dernier niveau (page courante) :\r\n\u2192 dans le CSS : change `color: #0d3182;` dans `.breadcrumb span`\r\n\r\n2. Modifier la couleur ou le style des liens :\r\n\u2192 dans `.breadcrumb a`, tu peux ajuster :\r\n- color (ex: #0073aa)\r\n- font-weight\r\n- text-transform\r\n\r\n3. Supprimer le fond gris clair :\r\n\u2192 supprime `background: #f4f6f8;` dans `.breadcrumb`\r\n\r\n4. Centrer le fil d\u2019Ariane :\r\n\u2192 ajoute `justify-content: center;` dans `.breadcrumb`\r\n\r\n5. Changer le s\u00e9parateur :\r\n\u2192 remplace `\u203a` dans le code HTML g\u00e9n\u00e9r\u00e9 (`.separator`)\r\nPar exemple : `&raquo;` (pour \u00bb) ou `\/`\r\n\r\n6. Supprimer \"Accueil\" du d\u00e9but :\r\n\u2192 commente ou supprime : `let html = '<a href=\"\/\">Accueil<\/a>';`\r\n\r\n7. Ajouter une classe sp\u00e9cifique au dernier segment :\r\n\u2192 tu peux remplacer `<span>` par `<span class=\"current\">` et styler `.current` comme tu veux\r\n\r\n8. Forcer un affichage responsive encore plus propre :\r\n\u2192 dans `.breadcrumb`, tu peux ajouter `flex-wrap: wrap;` et g\u00e9rer les `gap` ou marges\r\n\r\n\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\u2500\r\n*\/\r\n<\/script>\r\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-df26ddb e-con-full e-flex e-con e-parent\" data-id=\"df26ddb\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-176b749 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"176b749\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.23.0 - 15-07-2024 *\/\n.elementor-widget-text-editor.elementor-drop-cap-view-stacked .elementor-drop-cap{background-color:#69727d;color:#fff}.elementor-widget-text-editor.elementor-drop-cap-view-framed .elementor-drop-cap{color:#69727d;border:3px solid;background-color:transparent}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap{margin-top:8px}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap-letter{width:1em;height:1em}.elementor-widget-text-editor .elementor-drop-cap{float:left;text-align:center;line-height:1;font-size:50px}.elementor-widget-text-editor .elementor-drop-cap-letter{display:inline-block}<\/style>\t\t\t\t<h2>Qu\u2019est-ce que Le Spina Bifida ?<\/h2><p style=\"text-align: justify;\"><span style=\"font-size: 14pt;\">Le <em>spina bifida<\/em>, regroupe un vaste ensemble de malformations de la moelle \u00e9pini\u00e8re et de la colonne vert\u00e9brale. Le principal facteur de risque est la carence en <strong>acide folique<\/strong> (vitamine B9) au moment de la conception, et pendant le d\u00e9veloppement du f\u0153tus au tout d\u00e9but de la grossesse (1er mois). L\u2019acide folique est en effet indispensable au bon d\u00e9veloppement d\u2019une structure de l\u2019embryon appel\u00e9e tube neural, qui formera plus tard la moelle \u00e9pini\u00e8re et la colonne vert\u00e9brale. C\u2019est en cas d\u2019anomalie de fermeture de ce tube neural qu\u2019on parle de dysraphisme, ou spina bifida.<\/span><\/p><p style=\"text-align: justify;\"><span style=\"font-size: 14pt;\">Le CHU p\u00e9diatrique de Tours (h\u00f4pital Clocheville) est un centre de r\u00e9f\u00e9rence des maladies rares C-MAVEM (Chiari, malformations vert\u00e9brales et m\u00e9dullaires) dans la prise en charge du spina bifida.<\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4e03a6b elementor-widget elementor-widget-image\" data-id=\"4e03a6b\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.23.0 - 15-07-2024 *\/\n.elementor-widget-image{text-align:center}.elementor-widget-image a{display:inline-block}.elementor-widget-image a img[src$=\".svg\"]{width:48px}.elementor-widget-image img{vertical-align:middle;display:inline-block}<\/style>\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"302\" height=\"527\" src=\"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-content\/uploads\/sites\/18\/2025\/10\/spina-bifida.jpg\" class=\"attachment-full size-full wp-image-163\" alt=\"spina bifida\" srcset=\"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-content\/uploads\/sites\/18\/2025\/10\/spina-bifida.jpg 302w, https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-content\/uploads\/sites\/18\/2025\/10\/spina-bifida-172x300.jpg 172w\" sizes=\"(max-width: 302px) 100vw, 302px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-58c5116 e-con-full e-flex e-con e-parent\" data-id=\"58c5116\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-41e211e elementor-widget elementor-widget-text-editor\" data-id=\"41e211e\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h2 style=\"text-align: justify;\">Quels sont les sympt\u00f4mes\u00a0?<\/h2><p style=\"text-align: justify;\">En fonction de la s\u00e9v\u00e9rit\u00e9 de la malformation, les sympt\u00f4mes peuvent \u00eatre variables\u00a0:<\/p><ul style=\"text-align: justify;\"><li>Absence de sympt\u00f4mes dans les formes mineures<\/li><li><u>Signes cutan\u00e9s<\/u>: g\u00e9n\u00e9ralement en r\u00e9gion lombaire ou sacr\u00e9e, il peut s\u2019agir d\u2019une touffe de poil, d\u2019un angiome plan, d\u2019un lipome (boule de graisse), d\u2019une fossette \u2026<\/li><li><u>Signes neurologiques<\/u>: d\u00e9ficit moteur d\u2019un ou plusieurs membres, douleurs neuropathiques<\/li><li><u>Signes orthop\u00e9diques<\/u> : malpositions des pieds, scoliose, asym\u00e9trie de longueur d\u2019une membre<\/li><li><u>Troubles v\u00e9sico-sphinct\u00e9riens<\/u>: fuites urinaires ou f\u00e9cales (incontinence)<\/li><\/ul><h2 style=\"text-align: justify;\">Comment fait-on le diagnostic\u00a0?<\/h2><h4 style=\"text-align: justify;\">En ant\u00e9natal<\/h4><p style=\"text-align: justify;\">Certaines formes peuvent \u00eatre suspect\u00e9es sur les <strong>\u00e9chographies de grossesse<\/strong>\u00a0: on proposera alors une consultation de diagnostic ant\u00e9natal avec un neurochirurgien p\u00e9diatrique.<\/p><h4 style=\"text-align: justify;\">Apr\u00e8s la naissance<\/h4><p style=\"text-align: justify;\">Le premier signe faisant g\u00e9n\u00e9ralement \u00e9voquer le diagnostic\u00a0 est la pr\u00e9sence d\u2019un stigmate cutan\u00e9 dans le dos. Dans les cas les plus s\u00e9v\u00e8res, il existe un d\u00e9faut de recouvrement de la peau en regard de la malformation\u00a0: il s\u2019agit d\u2019un my\u00e9lom\u00e9ningoc\u00e8le ouvert, rare en France.<\/p><p style=\"text-align: justify;\">En cas de suspicion de <em>spina bifida<\/em> \u00e0 la naissance\u00a0: l\u2019examen \u00e0 r\u00e9aliser en premi\u00e8re intention est <strong>l\u2019\u00e9chographie m\u00e9dullaire<\/strong>, puis <strong>l\u2019IRM m\u00e9dullaire<\/strong> pour confirmer le diagnostic. Un scanner du rachis peut \u00e9galement \u00eatre r\u00e9alis\u00e9 en compl\u00e9ment si besoin.<\/p><p style=\"text-align: justify;\">Parfois il n\u2019existe pas de signe cutan\u00e9 \u00e9vocateur\u00a0: le diagnostic peut \u00eatre fait plus tardivement dans l\u2019enfance avec l\u2019apparition de signes cliniques.<\/p><h2 style=\"text-align: justify;\">Quels sont les diff\u00e9rents types de spina bifida\u00a0?<\/h2><p style=\"text-align: justify;\">Il existe une grande vari\u00e9t\u00e9 de <em>spina bifida\u00a0: <\/em>on les distingue g\u00e9n\u00e9ralement en deux cat\u00e9gories\u00a0: \u00ab\u00a0ouvert\u00a0\u00bb et \u00ab\u00a0ferm\u00e9\u00a0\u00bb, en fonction de la pr\u00e9sence ou non de recouvrement cutan\u00e9 en regard de la malformation.<\/p><p style=\"text-align: justify;\"><strong><em>Les spina bifida ouverts<\/em><\/strong>\u00a0: formes graves, de diagnostic ant\u00e9natal, il s\u2019agit d\u2019une urgence chirurgicale d\u00e8s la naissance de l\u2019enfant, qui doit \u00eatre encadr\u00e9e dans un centre r\u00e9f\u00e9rent de neurochirurgie p\u00e9diatrique<\/p><ul style=\"text-align: justify;\"><li>My\u00e9lom\u00e9ningoc\u00e8le<\/li><li>My\u00e9loschisis<\/li><\/ul><p style=\"text-align: justify;\"><em><strong>Les spina bifida\u00a0 ferm\u00e9s<\/strong>\u00a0: <\/em>formes plus fr\u00e9quentes, pouvant \u00eatre asymptomatiques, symptomatiques d\u00e8s la naissance, ou devenant symptomatiques au cours de la croissance de l\u2019enfant.<\/p><ul style=\"text-align: justify;\"><li>M\u00e9ningoc\u00e8le<\/li><li>Lipome du c\u00f4ne terminal<\/li><li>Lipome du filum terminal<\/li><li>Diast\u00e9matomy\u00e9lie<\/li><li>Limited dorsal my\u00e9loschisis (LDM)<\/li><li>Sinus dermique<\/li><\/ul><h2 style=\"text-align: justify;\">Faut-il op\u00e9rer\u00a0?<\/h2><p style=\"text-align: justify;\">Tous les spina bifida ne s\u2019op\u00e8rent pas\u00a0: certaines formes de lipomes du c\u00f4ne terminal asymptomatiques peuvent \u00eatre simplement surveill\u00e9es en consultation de neurochirurgie p\u00e9diatrique jusqu\u2019\u00e0 la fin de la croissance de l\u2019enfant.<\/p><p style=\"text-align: justify;\">Une <u>intervention chirurgicale<\/u> sera g\u00e9n\u00e9ralement propos\u00e9e aux autres formes de spina bifida, soit de fa\u00e7on prophylactique (c\u2019est-\u00e0-dire avant l\u2019apparition de sympt\u00f4mes), soit de fa\u00e7on syst\u00e9matique s\u2019il existe des sympt\u00f4mes (troubles neurologiques ou orthop\u00e9diques des membres inf\u00e9rieures, troubles v\u00e9sico-sphinct\u00e9riens).<\/p><h2 style=\"text-align: justify;\">Quel suivi apr\u00e8s l\u2019op\u00e9ration\u00a0?<\/h2><p style=\"text-align: justify;\">Le suivi est assur\u00e9 de fa\u00e7on conjointe avec le neurochirurgien, et en fonction de la malformation et des besoins de l\u2019enfant, par un chirurgien orthop\u00e9dique (scoliose, troubles de la statique des membres inf\u00e9rieurs), un m\u00e9decin de r\u00e9\u00e9ducation (gestion de la r\u00e9\u00e9ducation, de la spasticit\u00e9, mise en place d\u2019attelles et autres appareillages), un chirurgien visc\u00e9ral p\u00e9diatrique (gestion des troubles urinaires et sphinct\u00e9riens).<\/p><p style=\"text-align: justify;\">Il existe une <strong>consultation pluridisciplinaire spina<\/strong>, regroupant tous les intervenant afin de coordonner au mieux la pris en charge de l\u2019enfant.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-d2602cb e-con-full e-flex e-con e-parent\" data-id=\"d2602cb\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b78c106 elementor-widget elementor-widget-heading\" data-id=\"b78c106\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.23.0 - 15-07-2024 *\/\n.elementor-heading-title{padding:0;margin:0;line-height:1}.elementor-widget-heading .elementor-heading-title[class*=elementor-size-]>a{color:inherit;font-size:inherit;line-height:inherit}.elementor-widget-heading .elementor-heading-title.elementor-size-small{font-size:15px}.elementor-widget-heading .elementor-heading-title.elementor-size-medium{font-size:19px}.elementor-widget-heading .elementor-heading-title.elementor-size-large{font-size:29px}.elementor-widget-heading .elementor-heading-title.elementor-size-xl{font-size:39px}.elementor-widget-heading .elementor-heading-title.elementor-size-xxl{font-size:59px}<\/style><h2 class=\"elementor-heading-title elementor-size-default\">Liens utiles<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2f54d49 elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"2f54d49\" data-element_type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<link rel=\"stylesheet\" href=\"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-content\/plugins\/elementor\/assets\/css\/widget-icon-list.min.css\">\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/crmr-spina.fr\/crmr-spina\/les-composantes-du-crmr-spina\/\" target=\"_blank\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-link\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M326.612 185.391c59.747 59.809 58.927 155.698.36 214.59-.11.12-.24.25-.36.37l-67.2 67.2c-59.27 59.27-155.699 59.262-214.96 0-59.27-59.26-59.27-155.7 0-214.96l37.106-37.106c9.84-9.84 26.786-3.3 27.294 10.606.648 17.722 3.826 35.527 9.69 52.721 1.986 5.822.567 12.262-3.783 16.612l-13.087 13.087c-28.026 28.026-28.905 73.66-1.155 101.96 28.024 28.579 74.086 28.749 102.325.51l67.2-67.19c28.191-28.191 28.073-73.757 0-101.83-3.701-3.694-7.429-6.564-10.341-8.569a16.037 16.037 0 0 1-6.947-12.606c-.396-10.567 3.348-21.456 11.698-29.806l21.054-21.055c5.521-5.521 14.182-6.199 20.584-1.731a152.482 152.482 0 0 1 20.522 17.197zM467.547 44.449c-59.261-59.262-155.69-59.27-214.96 0l-67.2 67.2c-.12.12-.25.25-.36.37-58.566 58.892-59.387 154.781.36 214.59a152.454 152.454 0 0 0 20.521 17.196c6.402 4.468 15.064 3.789 20.584-1.731l21.054-21.055c8.35-8.35 12.094-19.239 11.698-29.806a16.037 16.037 0 0 0-6.947-12.606c-2.912-2.005-6.64-4.875-10.341-8.569-28.073-28.073-28.191-73.639 0-101.83l67.2-67.19c28.239-28.239 74.3-28.069 102.325.51 27.75 28.3 26.872 73.934-1.155 101.96l-13.087 13.087c-4.35 4.35-5.769 10.79-3.783 16.612 5.864 17.194 9.042 34.999 9.69 52.721.509 13.906 17.454 20.446 27.294 10.606l37.106-37.106c59.271-59.259 59.271-155.699.001-214.959z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Les composantes du CRMR Spin@<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.chu-tours.fr\/pemr-cvl\/anomalies-vertebrales-et-spina-bifida\/\" target=\"_blank\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-link\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M326.612 185.391c59.747 59.809 58.927 155.698.36 214.59-.11.12-.24.25-.36.37l-67.2 67.2c-59.27 59.27-155.699 59.262-214.96 0-59.27-59.26-59.27-155.7 0-214.96l37.106-37.106c9.84-9.84 26.786-3.3 27.294 10.606.648 17.722 3.826 35.527 9.69 52.721 1.986 5.822.567 12.262-3.783 16.612l-13.087 13.087c-28.026 28.026-28.905 73.66-1.155 101.96 28.024 28.579 74.086 28.749 102.325.51l67.2-67.19c28.191-28.191 28.073-73.757 0-101.83-3.701-3.694-7.429-6.564-10.341-8.569a16.037 16.037 0 0 1-6.947-12.606c-.396-10.567 3.348-21.456 11.698-29.806l21.054-21.055c5.521-5.521 14.182-6.199 20.584-1.731a152.482 152.482 0 0 1 20.522 17.197zM467.547 44.449c-59.261-59.262-155.69-59.27-214.96 0l-67.2 67.2c-.12.12-.25.25-.36.37-58.566 58.892-59.387 154.781.36 214.59a152.454 152.454 0 0 0 20.521 17.196c6.402 4.468 15.064 3.789 20.584-1.731l21.054-21.055c8.35-8.35 12.094-19.239 11.698-29.806a16.037 16.037 0 0 0-6.947-12.606c-2.912-2.005-6.64-4.875-10.341-8.569-28.073-28.073-28.191-73.639 0-101.83l67.2-67.19c28.239-28.239 74.3-28.069 102.325.51 27.75 28.3 26.872 73.934-1.155 101.96l-13.087 13.087c-4.35 4.35-5.769 10.79-3.783 16.612 5.864 17.194 9.042 34.999 9.69 52.721.509 13.906 17.454 20.446 27.294 10.606l37.106-37.106c59.271-59.259 59.271-155.699.001-214.959z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Centre de r\u00e9f\u00e9rence des anomalies vert\u00e9brales et Spina-Bifida<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.spina-bifida.org\/\" target=\"_blank\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-link\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M326.612 185.391c59.747 59.809 58.927 155.698.36 214.59-.11.12-.24.25-.36.37l-67.2 67.2c-59.27 59.27-155.699 59.262-214.96 0-59.27-59.26-59.27-155.7 0-214.96l37.106-37.106c9.84-9.84 26.786-3.3 27.294 10.606.648 17.722 3.826 35.527 9.69 52.721 1.986 5.822.567 12.262-3.783 16.612l-13.087 13.087c-28.026 28.026-28.905 73.66-1.155 101.96 28.024 28.579 74.086 28.749 102.325.51l67.2-67.19c28.191-28.191 28.073-73.757 0-101.83-3.701-3.694-7.429-6.564-10.341-8.569a16.037 16.037 0 0 1-6.947-12.606c-.396-10.567 3.348-21.456 11.698-29.806l21.054-21.055c5.521-5.521 14.182-6.199 20.584-1.731a152.482 152.482 0 0 1 20.522 17.197zM467.547 44.449c-59.261-59.262-155.69-59.27-214.96 0l-67.2 67.2c-.12.12-.25.25-.36.37-58.566 58.892-59.387 154.781.36 214.59a152.454 152.454 0 0 0 20.521 17.196c6.402 4.468 15.064 3.789 20.584-1.731l21.054-21.055c8.35-8.35 12.094-19.239 11.698-29.806a16.037 16.037 0 0 0-6.947-12.606c-2.912-2.005-6.64-4.875-10.341-8.569-28.073-28.073-28.191-73.639 0-101.83l67.2-67.19c28.239-28.239 74.3-28.069 102.325.51 27.75 28.3 26.872 73.934-1.155 101.96l-13.087 13.087c-4.35 4.35-5.769 10.79-3.783 16.612 5.864 17.194 9.042 34.999 9.69 52.721.509 13.906 17.454 20.446 27.294 10.606l37.106-37.106c59.271-59.259 59.271-155.699.001-214.959z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Association nationale Spina Bifida<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-a5b2694 e-flex e-con-boxed e-con e-parent\" data-id=\"a5b2694\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-702a939 elementor-widget elementor-widget-image\" data-id=\"702a939\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"518\" height=\"147\" src=\"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-content\/uploads\/sites\/18\/2025\/10\/logo-asso-spina-bifida.png\" class=\"attachment-full size-full wp-image-146\" alt=\"asso spina bifida\" srcset=\"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-content\/uploads\/sites\/18\/2025\/10\/logo-asso-spina-bifida.png 518w, https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-content\/uploads\/sites\/18\/2025\/10\/logo-asso-spina-bifida-300x85.png 300w\" sizes=\"(max-width: 518px) 100vw, 518px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Qu\u2019est-ce que Le Spina Bifida ? Le spina bifida, regroupe un vaste ensemble de malformations de la moelle \u00e9pini\u00e8re et de la colonne vert\u00e9brale. Le principal facteur de risque est la carence en acide folique (vitamine B9) au moment de la conception, et pendant le d\u00e9veloppement du f\u0153tus au tout d\u00e9but de la grossesse (1er [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":0,"parent":373,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_seopress_robots_primary_cat":"","_seopress_titles_title":"","_seopress_titles_desc":"","_seopress_robots_index":"","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"publishpress_future_action":{"enabled":false,"date":"2026-04-26 21:56:13","action":"change-status","newStatus":"draft","terms":[],"taxonomy":""},"_links":{"self":[{"href":"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-json\/wp\/v2\/pages\/413"}],"collection":[{"href":"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-json\/wp\/v2\/comments?post=413"}],"version-history":[{"count":10,"href":"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-json\/wp\/v2\/pages\/413\/revisions"}],"predecessor-version":[{"id":468,"href":"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-json\/wp\/v2\/pages\/413\/revisions\/468"}],"up":[{"embeddable":true,"href":"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-json\/wp\/v2\/pages\/373"}],"wp:attachment":[{"href":"https:\/\/www.chu-tours.fr\/neurochirurgie\/wp-json\/wp\/v2\/media?parent=413"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}