Surgical Treatment for Myelomeningocele Associated With Hydrocephalus in Neonate(6 Case Report and Review of the Literature) / 中国医师杂志

ABSTRACT

Objective To determine pathogenesis and the suitable time of operation for myelomeningocele associated with hydrocephalus in neonate.Methods 6 underwent head CT scanning, 2 lumbosacral CT scanning and 6 lumbosacral X radiography on 6 patients myelomeningocele complicated with hydrocephalus.Ventriculoperitoneal shunt and repair of the myelomeningocele were performed respectively for one patient.from 1 day to 28 day old.Operation stage 1 in 5 patients.Repair of the myelomeningocele concurred with ventriculoperitoneal shunt. Intracranial pressure was measured in shunting procedure.Results 4 patients had normal intracranial pressure,2 patients increased intracranial pressure in the 6 patients.The volume of the hernial sac had markedly diminished and status of hernial sac had greatly improved wall in the patient who wnderwent two-stage procedures after shunt procedure. Lumbosacral wound healing was good . No recurrent myelomeningocele was found, no hydrocephalus was seen using head CT scanning and clinical manifestation has improved in these patients who were followed up 6 month to 3 year.Conclusions Hydrocephalus may deteriorate the degree of lumbosacral myelomeningocele. Effecacy of vntriculoperitoneal shunt and repair of the myelomeningocele was excellent in myelomeningocele complicated with hydrocephalus in neonate.Micro-operative technique might prevent the occurrence of tethered cord.