As children born with a myelomeningocele grow, they most likely will need treatment such as medicines and physical therapy. Some may need aids like braces, crutches or wheelchairs. Soon after birth, though, treatment for your baby is surgery.
Surgery for Myelomeningocele
The child is in position for repair of his spina bifida.
Very soon after your baby is born, they will need surgery to fix the defect. Because part of your baby's spinal cord area is exposed, your baby is at risk of getting an infection or having more damage to the spinal cord. To lessen the risk, our neurosurgeons will operate within your baby's first 24 to 48 hours of life.
The goal of the surgery is to prevent infection and damage to your baby's spinal cord. The surgery does not help your baby develop function that they were not born with.
First, the neurosurgeon closes up the covering around the spinal cord (dura mater) so it is watertight. Then the neurosurgeon closes the muscles around the spinal cord. Finally, they close the skin over the open area.
Closing the spinal cord defect in spina bifida.
Some myelomeningoceles require the help of plastic surgeons. First, the plastic surgeon creates a skin graft flap. Usually, they take skin for the graft from the baby's back or bottom. They use the skin graft to close up the area of the myelomeningocele.
Many babies with a myelomeningocele also have too much cerebrospinal fluid in their heads (hydrocephalus). If your baby has severe hydrocephalus at birth, they may need surgery for a temporary drainage system in the first few days after birth. If a temporary system is used first, a permanent shunt will be placed when your baby is stable.
If your baby doesn't have hydrocephalus at birth, doctors wait to see if it develops later. If so, neurosurgeons put in a shunt at that time.
Not all babies with a myelomeningocele need a shunt. Most babies who need a shunt get one within 4 to 8 weeks of their birth.