Operative repair of lumbosacral myelomeningocele

Technical note

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  • 1 Departments of Neurosurgery, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
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✓ A technique is described for closure of lumbosacral myelomeningoceles. The pathological anatomy of these lesions is examined, and the junction of the skin and dura is identified as the “junctional zone.” This zone permits maximal preservation of the available dura for watertight closure after operative dissection. The junctional zone also serves as an anchor for traction sutures, permitting skin closure without tension. Seventy consecutive repairs have been completed by the authors without significant complications. There have been no instances of cerebrospinal fluid leaks, meningitis, or wound dehiscence. In all cases the repair was carried out rapidly and in a single stage.

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  • 1.

    Babcock WW: Spina bifida and its surgical treatment, with a description of an efficient osteoplastic operation. Penn Med J 14:770781, 1910 Babcock WW: Spina bifida and its surgical treatment, with a description of an efficient osteoplastic operation. Penn Med J 14:770–781, 1910

    • Search Google Scholar
    • Export Citation
  • 2.

    Bannister CM: A method of repair of myelomeningoceles. Br J Surg 59:445448, 1972 Bannister CM: A method of repair of myelomeningoceles. Br J Surg 59:445–448, 1972

    • Search Google Scholar
    • Export Citation
  • 3.

    Brocklehurst G, , Gleave JRW, & Lewin W: Early closure of myelomeningocele, with special reference to leg movement. Br Med J 1:666669, 1967 Brocklehurst G, Gleave JRW, Lewin W: Early closure of myelomeningocele, with special reference to leg movement. Br Med J 1:666–669, 1967

    • Search Google Scholar
    • Export Citation
  • 4.

    Clark DH, , Walsh JW, & Luce EA: Closure of myelorachischisis defects with reverse latissimus dorsi myocutaneous flaps. Neurosurgery 11:423425, 1982 Clark DH, Walsh JW, Luce EA: Closure of myelorachischisis defects with reverse latissimus dorsi myocutaneous flaps. Neurosurgery 11:423–425, 1982

    • Search Google Scholar
    • Export Citation
  • 5.

    Cohn GA, & Hamby WB: The surgery of cranium bifidum and spina bifida. A follow-up report of sixty-four cases. J Neurosurg 10:297300, 1953 Cohn GA, Hamby WB: The surgery of cranium bifidum and spina bifida. A follow-up report of sixty-four cases. J Neurosurg 10:297–300, 1953

    • Search Google Scholar
    • Export Citation
  • 6.

    Desprez JD, , Kiehn CL, & Eckstein W: Closure of large meningomyelocele defects by composite skin-muscle flaps. Plast Reconst Surg 47:234238, 1971 Desprez JD, Kiehn CL, Eckstein W: Closure of large meningomyelocele defects by composite skin-muscle flaps. Plast Reconst Surg 47:234–238, 1971

    • Search Google Scholar
    • Export Citation
  • 7.

    Fernandez-Serrats AA, , Guthkelch AN, & Parker SA: The prognosis of open myelocele with a note on a trial of Laurence's operation. Dev Med Child Neurol Suppl 13:6574, 1967 Fernandez-Serrats AA, Guthkelch AN, Parker SA: The prognosis of open myelocele with a note on a trial of Laurence's operation. Dev Med Child Neurol Suppl 13:65–74, 1967

    • Search Google Scholar
    • Export Citation
  • 8.

    Frazier CH: Spina bifida, in Frazier CH, & Allen AR (eds): Surgery of the Spine and Spinal Cord. New York/London: D Appleton, 1918, pp 265324 Frazier CH: Spina bifida, in Frazier CH, Allen AR (eds): Surgery of the Spine and Spinal Cord. New York/London: D Appleton, 1918, pp 265–324

    • Search Google Scholar
    • Export Citation
  • 9.

    Gurdjian ES, & Thomas LM: Spina bifida, in Gurdjian ES, & Thomas LM (eds): Operative Neurosurgery, ed 3. Baltimore: Williams and Wilkins, 1970, pp 447454 Gurdjian ES, Thomas LM: Spina bifida, in Gurdjian ES, Thomas LM (eds): Operative Neurosurgery, ed 3. Baltimore: Williams and Wilkins, 1970, pp 447–454

    • Search Google Scholar
    • Export Citation
  • 10.

    Guthkelch AN, , Pang D, & Vries JK: Influence of closure technique on results in myelomeningocele. Childs Brain 8:350355, 1981 Guthkelch AN, Pang D, Vries JK: Influence of closure technique on results in myelomeningocele. Childs Brain 8:350–355, 1981

    • Search Google Scholar
    • Export Citation
  • 11.

    Habal MB, & Vries JK: Tension free closure of large meningomyelocele defects. Surg Neurol 8:177180, 1977 Habal MB, Vries JK: Tension free closure of large meningomyelocele defects. Surg Neurol 8:177–180, 1977

    • Search Google Scholar
    • Export Citation
  • 12.

    Heimburger RF: Early repair of myelomeningocele (spina bifida cystica). J Neurosurg 37:594600, 1972 Heimburger RF: Early repair of myelomeningocele (spina bifida cystica). J Neurosurg 37:594–600, 1972

    • Search Google Scholar
    • Export Citation
  • 13.

    Kredel FE: Conservation of tissue in repair of myelomeningocele in the newborn. Ann Surg 131:865868, 1950 Kredel FE: Conservation of tissue in repair of myelomeningocele in the newborn. Ann Surg 131:865–868, 1950

    • Search Google Scholar
    • Export Citation
  • 14.

    Matson DD: Surgical repair of myelomeningocele. J Neurosurg 27:180186, 1967 Matson DD: Surgical repair of myelomeningocele. J Neurosurg 27:180–186, 1967

    • Search Google Scholar
    • Export Citation
  • 15.

    McDevitt NB, , Gillespie RP, & Woosley RE, et al: Closure of thoracic and lumbar dysraphic defects using bilateral latissimus dorsi myocutaneous flap transfer with extended gluteal fasciocutaneous flaps. Childs Brain 9:394399, 1982 McDevitt NB, Gillespie RP, Woosley RE, et al: Closure of thoracic and lumbar dysraphic defects using bilateral latissimus dorsi myocutaneous flap transfer with extended gluteal fasciocutaneous flaps. Childs Brain 9:394–399, 1982

    • Search Google Scholar
    • Export Citation
  • 16.

    McLone DG: Technique for closure of myelomeningocele. Childs Brain 6:6573, 1980 McLone DG: Technique for closure of myelomeningocele. Childs Brain 6:65–73, 1980

    • Search Google Scholar
    • Export Citation
  • 17.

    Mustardé JC: Meningomyelocele: the problem of skin cover. Br J Surg 53:3641, 1966 Mustardé JC: Meningomyelocele: the problem of skin cover. Br J Surg 53:36–41, 1966

    • Search Google Scholar
    • Export Citation
  • 18.

    Patterson TJS, & Till K: The use of rotation flaps following excision of lumbar myelomeningoceles. An aid to the closure of large defects. Br J Surg 46:606608, 1959 Patterson TJS, Till K: The use of rotation flaps following excision of lumbar myelomeningoceles. An aid to the closure of large defects. Br J Surg 46:606–608, 1959

    • Search Google Scholar
    • Export Citation
  • 19.

    Penfield W, & Cone W: Spina bifida and cranium bifidum. Results of plastic repair of meningocele and myelomeningocele by a new method. JAMA 98:454461, 1932 Penfield W, Cone W: Spina bifida and cranium bifidum. Results of plastic repair of meningocele and myelomeningocele by a new method. JAMA 98:454–461, 1932

    • Search Google Scholar
    • Export Citation
  • 20.

    Voorhies RM, & Fraser RAR: Fascial closure of low myelomeningocele repairs. Technical note. J Neurosurg 58:144145, 1983 Voorhies RM, Fraser RAR: Fascial closure of low myelomeningocele repairs. Technical note. J Neurosurg 58:144–145, 1983

    • Search Google Scholar
    • Export Citation
  • 21.

    Winston K, , Mickle P, & Schuster S: Closure of large skin defect associated with thoracolumbar rachischisis. Case report. J Neurosurg 47:781784, 1977 Winston K, Mickle P, Schuster S: Closure of large skin defect associated with thoracolumbar rachischisis. Case report. J Neurosurg 47:781–784, 1977

    • Search Google Scholar
    • Export Citation
  • 22.

    Zook EG, , Dzenitis AJ, & Bennett JE: Repair of large myelomeningoceles. Arch Surg 98:4143, 1969 Zook EG, Dzenitis AJ, Bennett JE: Repair of large myelomeningoceles. Arch Surg 98:41–43, 1969

    • Search Google Scholar
    • Export Citation

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