Health Encyclopedia

Meningocele repair

Definition

Meningocele repair is surgery to repair birth defects of the spine and spinal membranes. .

Alternative Names

Spina bifida repair; Myelomeningocele repair; Myelomeningocele closure

Description

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.

Indications

Meningocele repair may be performed on infants born with the following:

Meningocele, a birth defect in the bones of the spine that involves swelling of the tissue covering the spinal cord and brain
Myelomeningocele, a birth defect in which the backbone and spinal canal do not close before birth
Spina bifida, a birth defect that affects the spinal cord or its coverings

Risks

Risks related to this surgery include:

Fluid build up and pressure in the brain (hydrocephalus)
Increased chance of urinary tract infection
Infection or inflammation of the spinal cord
Paralysis, weakness, or sensation changes due to loss of nerve function

Risks for any anesthesia include:

Breathing problems
Reactions to medications

Risks for any surgery include:

Bleeding
Infection

Expectations after surgery

How well a patient does depends on the initial condition of the spinal cord and nerves. Possible outcomes range from normal development to various losses of muscle function.

The ability to walk and control bowel and bladder function depends on the location of the defect. Those that occur lower down on the spinal cord are associated with a better outcome.

Hydrocephalus ("water on the brain") develops in about 70% of patients with myelomeningocele. Some patients have hydrocephalus when they are born. A tube that drains the extra fluid from the brain to the belly area may have to be inserted.

Convalescence

The child will usually need to spend about 2 weeks in the hospital after surgery. The child must lay flat without touching the wound area. A tube to drain urine out of the body (bladder catheterization) is usually needed.

Review Date:11/2/2007
Reviewed By:Deirdre O’Reilly, M.D., M.P.H., Neonatologist, Division of Newborn Medicine, Children’s Hospital Boston and Instructor in Pediatrics, Harvard Medical School, Boston, Massachusetts.

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