The significance of the percentage of the defect size in spina bifida cystica in determination of the surgical technique.
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.
Ozveren
M F
MF
Department of Neurosurgery, School of Medicine, Firat University, 23200 Elazig, Turkey. fozveren@firat.edu.tr
Erol
F S
FS
Topsakal
C
C
Tiftikci
M T
MT
Akdemir
I
I
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