Pediatric Neurosurgery

Original Paper

Surgical Treatment of Myelomeningocele Carried Out at ‘Time Zero’ Immediately after Birth

Pinto F.C.G.a · Matushita H.a · Furlan A.L.B.e · Alho E.J.a · Goldenberg D.C.b · Bunduki V.c · Krebs V.L.J.d · Teixeira M.J.a

Author affiliations

aDivision of Neurosurgery, Departments of bPlastic Surgery and cObstetrics and dDiscipline of Pediatrics, Hospital das Clinicas, eSão Paulo University Medical School, São Paulo, Brazil

Keywords: MyelomeningoceleNeurosurgeryHydrocephalusShuntPediatric

Related Articles for ""
Pediatr Neurosurg 2009;45:114–118
https://doi.org/10.1159/000209285

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: March 31, 2008
Accepted: December 08, 2008
Published online: March 21, 2009
Issue release date: April 2009

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 4

ISSN: 1016-2291 (Print)
eISSN: 1423-0305 (Online)

For additional information: https://www.karger.com/PNE

Abstract

Background/Aims: To present a protocol of immediate surgical repair of myelomeningocele (MMC) after birth (‘time zero’) and compare this surgical outcome with the surgery performed after the newborn’s admission to the nursery before the operation. Methods: Data from the medical files of 31 patients with MMC that underwent surgery after birth and after admission at the nursery (group I) were compared with a group of 23 patients with MMC admitted and prospectively followed, who underwent surgery immediately after birth – ‘at time zero’ (group II). Results: The preoperative rupture of the MMC occurred more frequently in group I (67 vs. 39%, p < 0.05). The need for ventriculoperitoneal shunt was 84% in group I and 65% in group II and 4 of them were performed during the same anesthetic time as the immediate MMC repair, with no statistically significant difference. Group I had a higher incidence of small dehiscences when compared to group II (29 vs. 13%, p < 0.05); however, there was no statistically significant difference regarding infections. After 1 year of follow-up, 61% of group I showed neurodevelopmental delay, whereas only 35% of group II showed it. Conclusions: The surgical intervention carried out immediately after the birth showed benefits regarding a lower incidence of preoperative rupture of the MMC, postoperative dehiscences and lower incidence of neurodevelopmental delay 1 year after birth.

© 2009 S. Karger AG, Basel



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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: March 31, 2008
Accepted: December 08, 2008
Published online: March 21, 2009
Issue release date: April 2009

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 4

ISSN: 1016-2291 (Print)
eISSN: 1423-0305 (Online)

For additional information: https://www.karger.com/PNE

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2009, Vol.45, No. 2

April 2009

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