Management of the Patient with Myelomeningocele

Abstract

Myelomeningocele is the most common neural tube defect and it is the most severe birth defect that is compatible with survival. In the early 1950’s, the survival rate for the patients with myelomeningocele was about 10 percent. Today, large numbers of children with myelomeningocele are surviving into adulthood because of recent advances in the management of several important complications and monitorization of the nörological complications gains importance with the prerequisite of improving quality of life. Deterioration of clinical manifestations can be caused by undiagnosed shunt malfunction, progression of Chiari II symptoms, hydromyelia, and tethered cord syndrome, as well as orthopedic and urological complications. Optimal treatment requires specialized care to prevent, monitor, and treat a variety of potential complications that can affect neurological functions, quality of life, and survival of the patients. This care is ideally provided by a multidisciplinary team with expertise in pediatric subspecialties of neurosurgery, orthopedics, neurology, urology, and rehabilitation.