Clinical outcomes of myelomeningocele defect closure over 10 years |
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Authors: | Ahmet Murat Müslüman Semra Karşıdağ Deniz Özgür Sucu Arzu Akçal Adem Yılmaz Deniz Şirinoğlu Yunus Aydın |
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Institution: | 1. Clinic of Neurosurgery, ?i?li Etfal Education and Research Hospital (?i?li Etfal E?itim ve Ara?t?rma Hast.), Beyin ve Sinir Cerr, Klini?i, ?i?li, Istanbul 34381, Turkey;2. Clinic of Plastic and Reconstructive Surgery, ?i?li Etfal Education and Research Hospital, Istanbul 34381, Turkey;1. Department of Neurosurgery, PGIMER, Chandigarh, India;2. Department of Radiodiagnosis, PGIMER, Chandigarh, India;1. Department of Neurosurgery, Seoul St. Mary''s Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea;2. Department of Radiology, Seoul St. Mary''s Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea |
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Abstract: | We report our surgical procedures for the closure of myelomeningocele defects. A retrospective analysis of 162 patients (74 male 45.7%], 88 female 54.3%]) with myelomeningocele was performed and the relationship between hydrocephalus, neurological status and the level and size of the myelomeningocele was described according to type of defect closure. Patients were divided into four groups according to the size of the defect, which was classified into ranges of 0-24 cm(2), 25-39 cm(2), 40-60 cm(2) and >60 cm(2). Myelomeningocele occurred in the lumbar region in 114 patients (70%). The minimum defect size was 3×2 cm, and the maximum defect size was 15×15 cm (mean defect size=34.64 cm(2)). We found that primary closure can be performed on clean, small defects with an intact sac that contains cerebrospinal fluid and the neural placode. For defects larger than 25 cm(2) that contained perforated sacculas, more soft tissue for well-vascularized coverage was required. Bilateral V-Y fasciocutaneous flaps are a good choice for immediate coverage of myelomeningocele defects. |
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