Who needs surgery for pediatric myelomeningocele? A retrospective study and literature review
Insights
Children with myelomeningocele (MMC) undergo numerous surgeries throughout their lives. This study details the types and timing of surgical interventions required by an MMC patient cohort.
Area of Science:
- Pediatric Surgery
- Neurosurgery
- Urology
Background:
- Myelomeningocele (MMC) necessitates extensive and varied surgical interventions.
- Surgical needs evolve over a patient's lifetime, impacting quality of life.
Purpose of the Study:
- To summarize surgical interventions in a cohort of myelomeningocele patients.
- To analyze the types and timing of surgeries across different age groups.
Main Methods:
- Retrospective chart review and interviews of 84 myelomeningocele patients (age 1.8-21.9 years).
- Analysis of demographics, ambulatory status, neurological level, shunt status, Arnold-Chiari malformation, and surgical history.
- Surgical interventions categorized into neurosurgical, orthopedic, urinary, ulcer repair, and others.
Main Results:
- 84 patients required 663 surgeries; average age 14.5 years.
- Neurosurgical procedures, primarily shunt-related, were most frequent, especially in early childhood.
- Orthopedic surgeries peaked between 6-12 years, urological surgeries after age 6, and ulcer repairs after age 12.
Conclusions:
- Myelomeningocele is a complex condition requiring a high volume of diverse surgical procedures.
- Surgical management strategies must adapt to the patient's age and evolving clinical needs.
Introduction:
Children with myelomeningocele (MMC) are usually subjected to multiple surgeries. However, the number and type of surgeries are not the same in every patient with MMC over time. This report summarizes the surgical interventions in a cohort of several ages.
Materials And Methods:
Data on all of the patients with MMC, aged from 1 year and 10 months to 21 years and 11 months, were retrospectively reviewed at the Dona Estefânia Hospital in Lisbon, Portugal. Data were collected by chart review and individual interviews. The factors analyzed were demographics, ambulatory status, neurological level of involvement, shunt status, Arnold-Chiari malformation type II, surgical history, and occurrence of fracture. The surgical interventions were categorized as neurosurgical, orthopedic, urinary, ulcer repair and others.
Results:
A total of 84 alive were eligible and enrolled. The average age was 14 years and six months. A total of 59 patients received shunts (all but one ventriculoperitoneal). In the study group, the 84 patients required 663 surgeries. Neurosurgical interventions were the most frequent surgical procedure and predominated during the first 2 years of life. Surgical interventions related to shunts were the most common neurosurgical interventions. Orthopedic surgeries were more frequent in the age group 6-12 years. Urological surgeries were done mainly after 6 years of age. Surgical repair of pressure ulcers was more common after 12 years of age.
Conclusions:
Our study brings to light the complexity of this condition, with multiple surgeries among patients with MMC.
More Related Videos
05:17Author Spotlight: Scope of LE-ULBD as a Safe, Effective, and Minimally Invasive Approach to Treat Lumbar Spinal Stenosis
Published on: February 9, 2024
03:47A Retrospective Study on Endoscopic Surgery for the Treatment of Paravertebral Abscess in Spinal Tuberculosis Patients
Published on: October 25, 2024