Type of Surgery
Last updated: 02/17/2009
Results depend greatly on the extent of involvement of exposed neural tissue and the condition of the infant prior to surgery. A meningocele repair can have excellent results, as neural tissue does not extend into the protruding sac. In myelomeningocele,...
the amount of exposed neural tissue will determine the extent of lower limb weakness, or paralysis. The infant will usually spend a few weeks in the hospital after surgery before being able to be discharged home. As the child grows, it may be necessary to use braces, crutches, or a wheelchair for mobility. If surgery for hydrocephalus is successful, the prognosis is better. Children with a repaired myelomeningocele may be able to go to school, but will benefit from special education and associated services. There may be varying degrees of learning problems, and difficulties with the child's attention span. An effective bowel and bladder-training program can help make attending school easier. Because of muscle weakness or paralysis, a child with spina bifida will need physical therapy and may require future surgeries.
Meningocele repair is surgery to repair birth defects of the spine and spinal membranes. . For both meningoceles and myelomeningoceles, surgery consists of putting the spinal cord or nerve roots in their normal place and protecting them by closing the overlying meninges and skin.
A myelomeningocele should be closed within 24 hours of birth to prevent infection. A shunt is usually required to drain excess fluid. If the baby has fluid build-up in the brain, a shunt is usually put in when the myelomeningocele is repaired. Otherwise, most neurosurgeons wait about 3 days to place a shunt.
If hydrocephalus is present at birth and already causing problems, then the myelomeningocele repair and shunt are done at the same time.
After surgery, antibiotics are usually given to prevent infection.
Select comparative data from 1999 to 2006 include a decrease of 14 percent in the number of neurosurgeons in private practice and a decrease of 13 percent in the number of neurosurgeons in solo practice.
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