Publication year: 2012
Source:Journal of Clinical Neuroscience
Ahmet Murat Müslüman, Semra Karşıdağ, Deniz Özgür Sucu, Arzu Akçal, Adem Yılmaz, Deniz Şirinoğlu, Yunus Aydın
We report our surgical procedures for the closure of myelomeningocele defects. A retrospective analysis of 162 patients (74 male [45.7%], 88 female [54.3%]) with myelomeningocele was performed and the relationship between hydrocephalus, neurological status and the level and size of the myelomeningocele was described according to type of defect closure. Patients were divided into four groups according to the size of the defect, which was classified into ranges of 0–24cm2, 25–39cm2, 40–60cm2 and >60cm2. Myelomeningocele occurred in the lumbar region in 114 patients (70%). The minimum defect size was 3×2cm, and the maximum defect size was 15×15cm (mean defect size=34.64cm2). We found that primary closure can be performed on clean, small defects with an intact sac that contains cerebrospinal fluid and the neural placode. For defects larger than 25cm2 that contained perforated sacculas, more soft tissue for well-vascularized coverage was required. Bilateral V–Y fasciocutaneous flaps are a good choice for immediate coverage of myelomeningocele defects.
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