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Updated: Jan 27, 2026
11:01
Moderate Prenatal Alcohol Exposure and Quantification of Social Behavior in Adult Rats
Published on: December 14, 2014
10.2K
Low level myelomeningoceles: do they need prenatal surgery?
Pierre-Aurelien Beuriat1, Isabelle Poirot2, Frederic Hameury3
1Department of Pediatric Neurosurgery, Hôpital Femme Mère Enfant, 32 Avenue du Doyen Jean Lépine, 69677, Lyon Cedex, France.
Summary
Postnatal closure of myelomeningocele (MMC) in lower spinal levels (L4 and below) shows good functional outcomes with modern microsurgery. Prenatal surgery is not recommended for this patient group due to potential complications and favorable results with postnatal care.
Area of Science:
- Pediatric Neurosurgery
- Spina Bifida Research
- Fetal Surgery Outcomes
Background:
- Myelomeningocele (MMC) closure is standard postnatal care.
- Prenatal MMC closure offers potential benefits but carries risks.
- Lower-level MMC (L4 and below) typically has a better prognosis.
Purpose of the Study:
- Evaluate outcomes for MMC with L4 or lower vertebral levels.
- Discuss indications for prenatal MMC closure in this specific patient group.
Main Methods:
- Observational study of 29 children with sacral or lumbar (≤L4) MMC.
- All patients underwent postnatal MMC closure using microsurgical techniques.
- Data collected on outcomes including CSF diversion, Chiari II malformation, ambulation, and continence.
Main Results:
- 37.9% required CSF diversion; 58.6% had pre-existing Chiari II malformation.
- 89.7% achieved ambulation; 23% had normal bladder and 55% normal bowel control.
- All school-aged children attended school.
Conclusions:
- Postnatal closure of low-level MMC with microsurgery yields good functional outcomes.
- This approach presents low risks for mother and infant.
- Prenatal surgery is not advised for this subgroup of myelomeningocele patients.
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