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Alternative names Return to top
Spina bifida repair; Myelomeningocele repair; Myelomeningocele closureDefinition Return to top
A meningocele is a protrusion of cerebrospinal fluid and meninges (covering layers of the spinal cord and brain) into the tissues beneath the skin. Meningocele repair is a surgical procedure to drain the cerebrospinal fluid and repair and close birth defects of the spine and spinal membranes. It is used to treat the conditions listed below:
Description Return to top
Surgery is usually done within 24 hours after birth. While the baby is anesthetized, an incision is made in the sac around the spinal cord, and excess fluid is drained off. The spinal cord is then covered with the membranes (meninges). The skin is closed over the meninges, spinal cord, and nerves.Indications Return to top
Surgery is recommended if a meningocele or meningomyelocele are present.Risks Return to top
Risks for any anesthesia include the following:Expectations after surgery Return to top
The long-term results depend on the initial condition of the spinal cord and nerves. Outcomes range from normal development to various types of paralysis (paraplegia), depending on the level of spinal cord involvement. With modern treatments, greater than 85% of infants survive, and about 50% will be able to walk.
Hydrocephalus ("water on the brain") develops in about 70% of patients with myelomeningocele and it is already present in 5-10% of patients at birth.
In patients with myelomeningocele and developing hydrocephalus, most surgeons will wait for a few days after repairing the myleomeningocele to treat the hydrocephalus with a shunt to relieve raised intracranial pressure. If hydrocephalus is present at birth and is already compromising the infant's neurologic function, then myelomeningocele repair and shunting for hydrocephalus are done at the same time.
Postoperative antibiotics are routinely administered to prevent infection.
Convalescence Return to top
Patients usually spend about 2 weeks in the hospital after surgery. During this time the patient is kept flat without lying on the incision as it heals. Bladder catheterization is usually required. Update Date: 2/21/2003 Updated by: Elaine T. Kiriakopoulos, M.D., MSc, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA. Review provided by VeriMed Healthcare Network.
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Page last updated: 28 October 2004 |