Objective: T To find out best possible protocol to provide productive life to children born with myelomeningocele.
Study design: Descriptive study.
Place & Duration of study: Department of Neurosurgery, Jinnah Postgraduate Medical Centre Karachi from December 2001 to December 2006.
Patients and Methods: The medical record of 415 children with myelomeningocele operated at our center was reviewed retrospectively. The surgical & medical management protocol used for different sites of myelomeningocele was studied.
Results: The age of most of the patients at the time of myelomeningocele repair was between 25-30 days; however, children with ruptured myelomeningocele were consistently repaired early. All paraplegic patients with dorsolumbar myelomeningocele were treated with either a low-pressure ventriculoperitoneal (VP) shunt only, direct repair or both. Patients with cervical, dorsal and lumbo-sacral myelomeningocele requiring VP shunt were operated either simultaneously for both procedures or with delayed insertions of a VP shunt after treatment of ventriculitis All 16 patients with ruptured myelomeningocele (3.8%) were treated for repair as well as ventriculitis. Complications including CSF leak, wound infection or necrosis after repair of myelomeningocele occurred in 22 cases (5.3%). The postoperative follow up for all patients was 1- 2 years.
Conclusions: Surgical intervention with a low-pressure VP shunt in large dorsolumbar myelomeningocele produced good results.
Journal of Surgery Pakistan
Hashim, A. M.,
(2008). Management of myelomeningocele. Journal of Surgery Pakistan, 13(1), 7-11.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_surg_neurosurg/261