The Surgical Management of Myelomeningocele with a Preliminary Report of 31 Cases

Abstract

SummaryA case material of 31 myelomeningoceles from 1963–64 is presented. The two main principles for treatment were: no selection of candidates for surgery and surgery as early as possible. The rate of accompanying hydrocephalus amenable to treatment was 79 %. The total survival rate was 78 %Earlier communications on the subject are discussed and in view of these and our own experiences the following conclusions are drawn:1. The potential risk for future mental retardation in a new‐born with hydrocephalus cannot be regarded as a conbraindication for surgery.2. The existence or extent of paralysis of legs and/or sphincters are no contraindications for surgery.3. Contraindicating factors of social nature cannot be accepted in a civilized country.4. Early operation of myelomeningocele probably decreases the mortality and morbidity. The operative procedure is technically easier and the possibility of further damage to the neural elements is decreased.5. An effort should be made to establish communication between the open central canal and spinal subarachnoid space.