Spina bifida myelomeningocele repair, treatment and complications

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Spina bifida myelomeningocele repair, treatment and complications

  1. 1. Spina BifidaMyelomeningocele Repair,Treatment andComplicationsLearn more about Spina Bifida athttp://www.spinabifida.net
  2. 2. Myelomeningocele repairAge upto 72 hr after birthEvaluate CVS RS Genitourinary systemDelayed repair and shunt placement  risk ofmorbidity and infection
  3. 3. Plastic surgerySize of spinal defect and adjacent tissue need plasticsurgery to primary closure
  4. 4. Operative technique• To protect cord tissue, loss of CSF , minimize risk ofmeningitis• Incision : margin between arachnoid of neural placode anddystrophic epidermis• Resection epidermal and dermal tissue from the peripheryof neural placode• Monofilament suture• Reconstruct thecal sac, duraplasty with thoracolumbar fascia
  5. 5. complicationsEarly complication from repairSuperficial wound dehiscenceWound infectionMeningitisSepsis
  6. 6. complicationHydrocephalusMay develop in first 6 wk of lifeSign of increase ICP  increase HC,fullness of fontanelle, spiltsutureA shunt shold be perform
  7. 7. complicationChiari II malformationCaudal herniation of cerebellumRare but high mortalityApnea,cyanosis,bradycardia,dysphagia,nystagmus,opisthotonos,weakness,Hindbrain decompression for symptomatic Chiari IImalformation
  8. 8. complicationLatex allergy
  9. 9. Long term follow upMultidisciplinary teamNeurology, orthopedics , urologyCognitive & behavior
  10. 10. Questions?Learn more about Myelomeningocele and Spina Bifidaat http://www.spinabifida.net

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