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Review
. 2015 Sep;38(5):626-40.
doi: 10.1179/2045772314Y.0000000229. Epub 2014 Jul 16.

Who needs surgery for pediatric myelomeningocele? A retrospective study and literature review

Humberto Marreiros, Clara Loff, Eulália Calado
Review

Who needs surgery for pediatric myelomeningocele? A retrospective study and literature review

Humberto Marreiros et al. J Spinal Cord Med. 2015 Sep.

Abstract

Introduction: Children with myelomeningocele (MMC) are usually subjected to multiple surgeries. However, the number and type of surgeries are not the same in every patient with MMC over time. This report summarizes the surgical interventions in a cohort of several ages.

Materials and methods: Data on all of the patients with MMC, aged from 1 year and 10 months to 21 years and 11 months, were retrospectively reviewed at the Dona Estefânia Hospital in Lisbon, Portugal. Data were collected by chart review and individual interviews. The factors analyzed were demographics, ambulatory status, neurological level of involvement, shunt status, Arnold-Chiari malformation type II, surgical history, and occurrence of fracture. The surgical interventions were categorized as neurosurgical, orthopedic, urinary, ulcer repair and others.

Results: A total of 84 alive were eligible and enrolled. The average age was 14 years and six months. A total of 59 patients received shunts (all but one ventriculoperitoneal). In the study group, the 84 patients required 663 surgeries. Neurosurgical interventions were the most frequent surgical procedure and predominated during the first 2 years of life. Surgical interventions related to shunts were the most common neurosurgical interventions. Orthopedic surgeries were more frequent in the age group 6-12 years. Urological surgeries were done mainly after 6 years of age. Surgical repair of pressure ulcers was more common after 12 years of age.

Conclusions: Our study brings to light the complexity of this condition, with multiple surgeries among patients with MMC.

Keywords: Myelomeningocele; Quality of life; Surgery.

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Figures

Figure 1
Figure 1
Graph showing the distribution of the number and type of surgical interventions according to the age group.
Figure 2
Figure 2
Distributions of neurosurgical interventions according to age.
Figure 3
Figure 3
Distribution of neurosurgical interventions in patients older than 1 year of age.
Figure 4
Figure 4
Distribution of orthopedic intervention according to age.
Figure 5
Figure 5
Distribution of pathological fractures and neurosurgical and orthopedic interventions over time.
See this image and copyright information in PMC

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