Repair of Myelomeningocele: How I Do It.

Myelomeningocele is the most common form of the spinal dysraphism. The objective of this paper is to describe a simple surgical technique for repair of myelomeningocele as it is carried out in our centre. Most of our patients present beyond the golden hours (24-36hours) for emergency repair with an already infected or ruptured lesions and therefore have to be on dressing of the wound to allow for complete healing. Surgery is just one aspect of management of patients with myelomeningocele. The urologist, orthopaedic surgeon, paediatrician, psychotherapist and physiotherapist all play a major role in the early and late management of these patients as a team. The aim of surgery is to recreate anatomic barriers over the delicate neural tissues preventing their desiccation and retrograde infection. It is to be emphasized that the repair does not improve the neurological deficits already present at birth and this must be properly explained to the family of the patient.