Complications of myelomeningocele closure

David G. McLone*, Mark S. Dias

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

50 Scopus citations

Abstract

Closure of a myelomeningocele is a deceptively simple operation; however, attention to several subtle details can significantly reduce operative complications. Important preoperative concerns include social issues of dealing with a distraught and often overwhelmed family, the timing of surgery, and assessment of associated severe or life- threatening malformations. Operative intervention should be directed toward preserving neurological function and optimizing the subsequent repair of a tethered spine should this become necessary. Careful attention to the vascular supply to the placode, precise separation of neural from cutaneous tissues, a diligent search for associated tethering anomalies such as diastematomyelia and a thickened filum terminate, careful pia to pia reconstruction of the placode, and simple but meticulous wound closure all help in achieving these aims. The timely management of associated hydrocephalus will help to avoid cerebrospinal fluid leakage and wound breakdown. Close attention to these details will ameliorate many of the immediate and delayed complications of myelomeningocele closure.

Original languageEnglish (US)
Pages (from-to)267-273
Number of pages7
JournalPediatric Neurosurgery
Volume17
Issue number5
DOIs
StatePublished - Jan 1 1991

Keywords

  • Complications
  • Myelomeningocele
  • Spina bifida
  • Spinal cord
  • Spinal dysraphism

ASJC Scopus subject areas

  • Clinical Neurology
  • Pediatrics, Perinatology, and Child Health
  • Surgery

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