Neuroplastic surgery for adulthood myelomeningocele: Advancement flap reconstruction

While it is widely recognized that surgical intervention is crucial at birth, the occurrence of giant myelomeningocele in adulthood is exceedingly uncommon. This case study aims to provide a comprehensive overview of a rare presentation of myelomeningocele accompanied by a tethered cord in an adult patient, highlighting the clinical features, diagnostic imaging, and surgical repair technique employed.

This patient is a 58-year-old woman with a history of spinal dysraphism that was diagnosed during childbirth. Due to her family's low sociocultural status, she did not receive timely treatment. She was referred to our institution because of a persistent increase in volume in the lumbar region, accompanied by a continuous and intense pulsating headache. An magnetic resonance imaging revealed a giant spinal defect caused by lumbar dysraphism. A surgical rotational flap procedure and untethering of the spinal cord using microsurgical techniques were performed. During follow-up, the patient experienced a complete recovery of her clinical symptoms.

Surgical treatment can benefit adult patients with symptomatic myelomeningocele. This would influence the quality of life for the patient. For large lesions in the spine, adequate flap rotation demands knowledge of how to do it.