Myelomeningocele Primary Repair Surgical Technique

Caldarelli, Massimo; Rocco, Concezio Di

doi:10.1007/978-88-470-0651-5_10

Cited by 16 publications

(23 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The chances of ventriculitis becomes higher if the MMC correction is performed 72 hours postnatally. 9 Findings in the present study corresponds to the evidence in the Literature that neonates who underwent surgery after 72 hours of delivery had a higher chance of meningitis and ventriculitis. There is controversy regarding the timing of shunt operation in patients who have both MMC and hydrocephalus.…”

Section: Discussionsupporting

confidence: 91%

“…It is believed that inserting a ventriculoperitoneal shunt at the time of MMC correction does not contribute to infection. 9 However few studies have reported that frequency of ventriculoperitoneal shunt infections increased when shunt insertion and correction operation are performed in the same sitting. 10 In present study we observed that shunt infection was found in only one patient and we suggest that the shunt insertion and correction procedure should be done together.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Evaluation and Management of Children with Meningomyelocoele

Shukla¹,

Chaube²

2020

jebmh

View full text Add to dashboard Cite

BACKGROUND Neural tube defects (NTDs) are one of the most common birth defects affecting the Central Nervous System (CNS) and is often associated with complex birth defects compatible with survival. 1 NTD is a general term for a congenital malformation of the central nervous system (CNS) occurring secondary to lack of closure of the neural tube and has a worldwide incidence of 1.0 to 10.0 per 1,000 births. Congenital malformations of spine and spinal cord are collectively termed as spinal dysraphism. It includes a heterogenous group of anomalies resulting from incomplete midline closure of osseous, mesenchymal and nervous tissue. 2 Most of these conditions are diagnosed at or soon after birth, but some are diagnosed late in childhood or in adulthood because of absence of clinical manifestations. We wanted to evaluate the causative factors, clinical features, management and postoperative complications of children with meningomyelocoele. METHODS This is a retrospective study and all children having meningomyelocoele born between April 2014 to May 2016 were included in the study. Clinical features, maternal educational status, size and location of the defect, operative details such as time to surgery and its relation to postoperative morbidity and mortality were recorded. RESULTS A total of 36 patients were evaluated in the study period. There were 20 (55.6%) males and 16 (44.4%) females. Most common location of MMC was in lumbar (83.3%) and followed by thoracolumbar (16.7%) regions. None of the mothers received folate supplementation. Hydrocephalus (n = 18), pelvicalyceal ectasia (n = 3), pes equinovarus (n = 7), Chiari II malformation (n = 4)), pelvicalyceal ectasia (n = 3), hip dysplasias (n = 2), accounted for additional anomalies. Short term complications following surgery were bladder dysfunction in 8 patients (22.2%), 7 patients (19.4%) had seizures, 6 patients (16.7%) had bacterial meningitis and 3 patients (8.3%) had severe hydrocephalus and 4 patients (11.1%) had ventriculitis. CONCLUSIONS Operating on patients with meningomyelocoele with in 72 hrs. of birth reduces complications, hospital stay and antibiotic usage.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Clinical Evaluation and Management of Children with Meningomyelocoele

Shukla¹,

Chaube²

2020

jebmh

View full text Add to dashboard Cite

show abstract

“…19 The literature defines several factors that may contribute to the development of hydrocephalus, such as stenosis of the cerebral aqueduct, fourth ventricle outlet obstruction, obliteration in the region of the posterior fossa, or obstruction of the posterior fossa at the tentorial notch. 19 These potential causes, however, cannot explain why hydrocephalus occurs after MMC closure in most cases. At birth, hydrocephalus is present in < 15% of newborns and manifests with symptoms of increased intracranial pressure.…”

Section: Discussionmentioning

confidence: 99%

“…At birth, hydrocephalus is present in < 15% of newborns and manifests with symptoms of increased intracranial pressure. 19 This relatively small group of patients requires early treatment for hydrocephalus. 19 In most patients, however, hydrocephalus occurs after the surgical closure of MMC.…”

Section: Discussionmentioning

confidence: 99%

“…19 This relatively small group of patients requires early treatment for hydrocephalus. 19 In most patients, however, hydrocephalus occurs after the surgical closure of MMC. 20 A treatment approach in which surgery for MMC and shunt placement are performed during one procedure has the advantage of better wound healing as a result of decreased CSF pressure.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Survey on Current Postnatal Surgical Management of Myelomeningocele in Germany

Mauer¹,

Jahn²,

Unterreithmeir³

et al. 2016

J Neurol Surg A Cent Eur Neurosurg

View full text Add to dashboard Cite

Although postnatal surgery can be regarded as the standard of care for open myelomeningocele (MMC), there is no uniform treatment for this condition in Germany. This study assessed the current situation regarding the management of open MMC, a first and essential step toward the development of standards of practice. In the second half of 2009, we had sent standardized questionnaires to 139 neurosurgery departments and 73 pediatric surgery departments (number of returned questionnaires: 98 and 62, respectively) to identify the principles of MMC management. Newborns with open MMC are treated in 57 of the neurosurgery departments and in 18 of the pediatric surgery departments. Overall, 41 of the 57 neurosurgery departments and 16 of the 18 pediatric surgery departments providing care for newborns with MMC perform MMC closure within 24 hours of delivery. In 52 neurosurgery departments and 15 pediatric surgery departments, infants with spina bifida are delivered by planned cesarean section. The diagnostic investigations performed between the time of caesarean delivery and plastic surgical closure vary from none to magnetic resonance imaging of the spine. The criteria underlying the placement of shunts and the time to plastic surgical closure are highly variable. The type of treatment that infants with open MMC receive in Germany differs from institution to institution. Clear and consistent guidelines must be established using an interdisciplinary approach to improve treatment and standardize the care provided by surgical specialists for infants with MMC.

show abstract