How is the meningocele and myelomeningocele surgery performed?

Meningocele and myelomeningocele, both neural tube defects, can be treated with surgery. The surgical procedure may vary slightly, but the overall steps are similar.

1. Preoperative Preparation:

- The child undergoes a thorough evaluation to assess their overall health and any associated medical conditions.

- Depending on the age and condition of the child, the surgery may be performed under general anesthesia.

2. Incision:

- The surgeon makes an incision along the midline of the back, directly over the affected area.

- The length of the incision depends on the extent of the neural tube defect.

3. Exposure of the Neural Tube Defect:

- The surgeon carefully separates the skin, muscles, and other tissues to expose the meninges, the protective layers surrounding the spinal cord and nerve roots.

4. Repair of the Defect:

- For meningoceles, the surgeon carefully removes the sac containing cerebrospinal fluid (CSF) without causing damage to the surrounding neural structures.

- For myelomeningoceles, which involve the protrusion of the spinal cord and nerve roots, the surgeon gently replaces the exposed neural tissue back into the spinal canal.

- The defect is then closed using sutures or patches of synthetic or biological material to cover the opening and prevent CSF leakage.

5. Closure of the Incision:

- The surgeon closes the incision with sutures and applies dressings to protect the surgical site.

6. Postoperative Care:

- The child will typically need to stay in the hospital for observation after surgery.

- They will receive medications to manage pain and prevent complications, and wound care will be provided.

- Regular monitoring of the child's neurological function, such as movement, sensation, and bladder control, will be essential to assess any potential complications.

It's important for the surgical team to have expertise in pediatric neurosurgery and spina bifida management to achieve the best possible outcome. Additionally, rehabilitation and long-term follow-up care are often crucial for the child's overall well-being and development.