title: The significance of the percentage of the defect size in spina bifida cystica in determination of the surgical technique.
abstract: OBJECTIVE
  Our aim was to classify meningoceles and meningomyeloceles in terms of defect area as a percentage of the thoracolumbar region to make it possible to select the surgical technique accordingly.
  
  
  METHODS
  Thirty-two cases were included in the study program. Any defect smaller than 8% of the thoracolumbar region was primarily sutured and classed as grade 1.
  
  
  RESULTS
  The defects that it was not possible to handle with primary suture because of the broad base and thereby closed with muscle-skin flaps were those occupying more than 8% of the thoracolumbar region and these were classed as grade 2. It was not possible to perform primary repair of any defect occupying more than 8% of the thoracolumbar area.
  
  
  CONCLUSIONS
  The use of combined latissimus dorsi+gluteus maximus muscle-skin flaps was found to be safe in broad-based meningomyelocele defects, as they provide wider closures and permanent bolstering of the meningomyelocele defect, thus protecting the region against multiple trauma.
authors.affiliation: Department of Neurosurgery, School of Medicine, Firat University, 23200 Elazig, Turkey. fozveren@firat.edu.tr
authors.forename: M F
authors.initials: MF
authors.lastname: Ozveren
authors.forename: F S
authors.initials: FS
authors.lastname: Erol
authors.forename: C
authors.initials: C
authors.lastname: Topsakal
authors.forename: M T
authors.initials: MT
authors.lastname: Tiftikci
authors.forename: I
authors.initials: I
authors.lastname: Akdemir
mesh_terms: D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008588:Meningocele / Q000473:pathology / Q000601:surgery; D008591:Meningomyelocele / Q000473:pathology / Q000601:surgery; D016137:Spina Bifida Cystica / Q000473:pathology* / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome