[How I do it: myelomeningocele]
1Center for World Health, Department of Neurosurgery, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA.
Fortification of food with folic acid is effective. Work needs to be done to raise the awareness of its importance among young couples. Prenatal consult is crucial in countries where abortion is legal. I use microscope to enhance the learning experience of the resident. For that I irrigate frequently the placode to reduce the heat from the lamp. I treat the placode as viable tissue. I don’t suture the placode. I use dura patch if required to increase the space in the canal. I don’t close muscle. Hydrocephalus: Shunt in case of ventriculomegaly. Tethered cord: At least one untethering, not completely convinced about repeated untethering. Chiari II: Revise the shunt. Follow up: Factor academic performance as an indicator of subtle shunt failure or tethered cord.
Fortification of food with folic acid is effective. Work needs to be done to raise the awareness of its importance among young couples. Prenatal consult is crucial in countries where abortion is legal. I use microscope to enhance the learning experience of the resident. For that I irrigate frequently the placode to reduce the heat from the lamp. I treat the placode as viable tissue. I don’t suture the placode. I use dura patch if required to increase the space in the canal. I don’t close muscle. Hydrocephalus: Shunt in case of ventriculomegaly. Tethered cord: At least one untethering, not completely convinced about repeated untethering. Chiari II: Revise the shunt. Follow up: Factor academic performance as an indicator of subtle shunt failure or tethered cord.
