Prenatal Evaluation of Myelomeningocele: A Neurosurgical Perspective

Abstract

Myelomeningocele is a neural tube defect that can be diagnosed in utero. The standard of care is postnatal surgery for repair of the open spinal defect, although prenatal surgery is now offered in some institutions. This article considers the prognosis and management decisions of myelomeningocele with special emphasis on prenatal counseling and treatment planning.

Meningomyelocele Simulation Model: Pre-surgical Management–Technical Report

“…Obstetricians can participate in scenarios so that the delivery and hand-off can be practiced in a safe, simulated environment with the opportunity to debrief and reflect. Neurosurgeons, who rarely participate in the resuscitation due to logistical constraints, can have input in standardizing and improving care for the spinal lesion during the resuscitation, allowing the patient to arrive in the best possible condition prior to surgical intervention [ 4 ].…”

The Prevalence of Post-operative Complications Following Meningomyelocele Repair

“…Families with lower socioeconomic levels are more vulnerable, as are those with poor food quality and hygiene. 4 Myelomeningocele (MMC) is the most common central nervous system abnormality, occurring in up to 71% of babies. 8 The incidence is reported to be between 3 and 6 per 1000 live births.…”

“…Following surgery, there is a motor improvement (30.5%), sensory (22.9%), and sphincteric function (14.1%). [2][3][4][5] The most common post-operative complications are meningitis/shunt infection (16.4%), surgical wound infection (11%), and wound dehiscence (8.3%). Other investigations found that 21 patients (13.5%) exhibited evidence of surgical site infection, 135 patients (86.5%) had wounds that healed effectively, 37 patients (23.7%) experienced CSF leaking, and 119 patients (76.3%) recovered entirely.…”