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. 2021 Aug 13;16(1):494.
doi: 10.1186/s13018-021-02643-8.

Orthopedic management of myelomeningocele with a multidisciplinary approach: a systematic review of the literature

Parnian Shobeiri  1   2   3 , Ana Presedo #  4 , Amirali Karimi #  1 , Sara Momtazmanesh  1   2 , Fardis Vosoughi  5   6 , Mohammad Hossein Nabian  7   8
Affiliations

Orthopedic management of myelomeningocele with a multidisciplinary approach: a systematic review of the literature

Parnian Shobeiri et al. J Orthop Surg Res. .

Abstract

Background: Myelomeningocele (MMC) is the most common and severe form of spina bifida and imposes a significant burden on patients and the healthcare system. Recently, the multidisciplinary management of MMC has become popular. Herein, we aimed to review the orthopedic management, outcomes, and complications of the of patients with MMC eyeing a multidisciplinary approach.

Methods: We searched PubMed and EMBASE to find relevant studies published before August 2020. All studies that included clinical management of MMC patients and published earlier than 2000 were considered for review on the condition that they reported at least one orthopedic intervention and the rate of complications. We excluded review articles, case reports, case series, letters, commentaries, editorials, and conference abstracts. The primary and secondary goals of our review were to report the outcomes and complication rates of multidisciplinary management for MMC patients.

Results: Twenty-six studies included data for the management of 229,791 patients with MMC and were selected. Sixteen studies reported multidisciplinary management in addition to orthopedic management. From those, 11 (42.31%) included urologic management, 13 (50%) neurosurgical management, 11 (42.31%) neurologic management, and 5 (19.23%) gastrointestinal management. All studies included postnatal operations and related management. No randomized clinical trial was found in our search.

Conclusion: Orthopedic approaches play a key role in MMC management by alleviating spinal deformities, particularly scoliosis, and hip, foot, and ankle complications. However, the most appropriate management, whether surgical or non-surgical, may vary for different patients, given disease severity and the age of patients.

Keywords: Communication; Interdisciplinary; Meningomyelocele; Orthopedics; Spinal dysraphism.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Search strategy
Fig. 2
Fig. 2
Study selection process according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline
See this image and copyright information in PMC

References

    1. Copp AJ, Adzick NS, Chitty LS, Fletcher JM, Holmbeck GN, Shaw GM. Spina bifida. Nat Rev Dis Primers. 2015;1:15007. doi: 10.1038/nrdp.2015.7. - DOI - PMC - PubMed
    1. Russo CA, Elixhauser A. Hospitalizations for birth defects, 2004: Statistical Brief #24. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Rockville (MD): Agency for Healthcare Research and Quality (US); 2006. - PubMed
    1. Dolk H, Loane M, Garne E. The prevalence of congenital anomalies in Europe. Adv Experiment Med Biol. 2010;686:349–364. doi: 10.1007/978-90-481-9485-8_20. - DOI - PubMed
    1. Meuli M, Meuli-Simmen C, Hutchins GM, Seller MJ, Harrison MR, Adzick NS. The spinal cord lesion in human fetuses with myelomeningocele: implications for fetal surgery. J Pediatr Surg. 1997;32(3):448–452. doi: 10.1016/S0022-3468(97)90603-5. - DOI - PubMed
    1. McCarthy DJ, Sheinberg DL, Luther E, McCrea HJ. Myelomeningocele-associated hydrocephalus: nationwide analysis and systematic review. Neurosurg Focus. 2019;47(4):E5. doi: 10.3171/2019.7.FOCUS19469. - DOI - PubMed

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