[Problems in managing the newborn infant with lumbosacral meningomyelocele: basis for comprehensive care]

Newborns affected by spina bifida with myelomeningocele has been managed in Bologna by a team of neurosurgeons and neonatologists, whose experience is described here. Among the main problems faced during a ten years period are: selection of infants for surgical correction, treatment schedule and follow up program, nursing protocol in an intensive care unit. Basing on their personal work and an exhaustive literature's revision, the authors emphasize the opportunity of delaying surgery until local and general conditions are improved and a careful evaluation of the patient has been achieved. An appropriate pre and post operative nursing is mandatory. But the whole therapeutic program and furthermore any rehabilitation chance has their cornerstone in a full cooperation among the several specialists involved. The neonatologist first, the family pediatrician later can act as the pivot for the team, in order to achieve a comprehensive approach and an "overall" management for the individual affected child.