Congenital Back Deformity: Meningomyelocele

 Meningomyelocele: Congenital Back Deformity

Meningomyelocele is a congenital condition characterized by the protrusion of both the meninges and the spinal cord through a defect in the spinal column. This condition typically presents as a sac-like protrusion containing the spinal cord, nerves, and cerebrospinal fluid.

Children born with such defects are prone to numerous problems starting from the day of their Birth.

Apart from the open spinal canal (bony defect) there may be exposed spinal nerves, spinal cord coverings (meninges) with CSF leak. There may or may not be skin present over the defect or the skin may be ulcerated with risk of impending exposure.

2 DAY OLD INFANT WITH IMPENDING EXPOSURE OF SPINAL CORD

Management : Team Work

Reconstructive surgeon (Plastic Surgeon)

Neurosurgeon

Orthopedician

Urologist

Pediatrician

Geneticist

Social worker

Treatment: Surgical closure of the defect and coverage with skin flaps

VY ADVANCEMENT FLAP AFTER DURAL COVER

AFTER SUTURE REMOVAL

There are numerous methods of closure of the skin defect and the choice has to be made according to the site of the lesion, the risk benefit ratio of various options available.

MYOCUTANEOUS FLAP COVERAGE OPTIONS

Surgery is not the endpoint of care. 

IT DOES IMPROVE THE 5 YEAR SURVIVAL FROM 10% IN UNTREATED INFANT TO 50% POST SURGERY.

DR. ASHISH GUPTA

DIRECTOR

DEPT OF PLASTIC, MICROVASCULAR & COSMETIC SURGERY,

DEEP HOSPITAL, LUDHIANA