Meningocele Repair

Definition

Meningocele repair is surgery to repair birth defects of the spine and spinal membranes. It is used to treat a meningocele, a birth defect in the bones of the spine that involves swelling of the tissue covering the spinal cord and brain. It is also used to treat spina bifida and myelomeningocele.

Central nervous system
Meningocele repair - series

Alternative Names

Description

For both meningoceles and myelomeningoceles, surgery consists of putting the spinal cord or nerve roots in their normal place and protecting them by closing the overlying meninges and skin.

A myelomeningocele should be closed within 24 hours of birth to prevent infection. A shunt is usually required to drain excess fluid. If the baby has fluid build-up in the brain, a shunt is usually put in when the myelomeningocele is repaired. Otherwise, most neurosurgeons wait about 3 days to place a shunt.

If hydrocephalus is present at birth and already causing problems, then the myelomeningocele repair and shunt are done at the same time.

After surgery, antibiotics are usually given to prevent infection.

Indications

Surgery is recommended if a meningocele or meningomyelocele is present.

Risks

Risks for any anesthesia include:

• Reactions to medications
• Problems breathing

Risks for any surgery include:

• Bleeding
• Infection

Additional risks include:

• Excessive fluid and pressure in the brain (hydrocephalus)
• Infection or inflammation of the spinal cord (meningitis)
• Paralysis, weakness, or sensation changes due to loss of nerve function
• Increased chance of urinary tract infection

Expectations after surgery

How well a patient does depends on the initial condition of the spinal cord and nerves. Possible outcomes range from normal development to various types of paralysis (paraplegia). With treatment, greater than 85% of infants survive, and about 50% will be able to walk.

Hydrocephalus ("water on the brain") develops in about 70% of patients with myelomeningocele. Some patients have hydrocephalus when they are born.

Convalescence

Patients usually spend about 2 weeks in the hospital after surgery and must lay flat without touching the wound area. A tube to drain urine out of the body (bladder catheterization) is usually needed.

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Review Date:10/16/2006
Reviewed By: J.A. Lee, M.D., Assistant Professor of Surgery, Columbia University Medical Center, New York, NY. Review provided by VeriMed Healthcare Network.