imagem top



CHULC LOGOlogo HDElogo anuario

Who needs surgery for pediatric myelomeningocele? A retrospective study and literature review

Humberto Marreiros1, Clara Loff2, Eulália Calado1

1- Department of Paediatric Neurology, Dona Estefânia Hospital, Lisbon
2- Department of Physical and Rehabilitation Medicine, Dona Estefânia Hospital, Lisbon

Journal Spinal Cord Medicine. 2014 Jul 16

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, ArnoldChiari 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 612 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.

Palavras Chave: Mielomeningocelo, cirurgia, pediatria, retrospectivo