title: Surgical technique and outcome in cervical and thoracic myelomeningocoele surgery.
abstract: Cervical and thoracic myelomeningocoeles differ from common lumbosacral myelomeningocoeles in many respects. We review the surgical technique and outcome achieved for a series of six infants who underwent surgery for cervical or thoracic myelomeningocoele. Five patients, who had intradural exploration and microsurgical untethering of the spinal cord, were neurologically stable on follow-up. The other patient, who had a simple subcutaneous resection of the sac without release of the intradural tethering bands, was re-operated on 16 months later, with progressive neurological symptoms due to cord tethering. Following re-exploration and microsurgical untethering of the spinal cord, the neurological deficits significantly improved. We suggest that the surgical technique in these lesions should include careful intradural exploration and microsurgical release of the spinal cord by meticulous resection of all tethering bands. This enables postoperative neurological improvement and possible prevention of future neurological deficits due to cord tethering.
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Kocaeli University, 41900, Derince, Kocaeli, Turkey. drvolkanetus@yahoo.com
authors.forename: Volkan
authors.initials: V
authors.lastname: Etus
authors.forename: Hasan Tahsin
authors.initials: HT
authors.lastname: Sarisoy
authors.forename: Savas
authors.initials: S
authors.lastname: Ceylan
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000379:methods; D008591:Meningomyelocele / Q000601:surgery*; D012189:Retrospective Studies; D013118:Spinal Cord Diseases / Q000601:surgery*; D019616:Thoracic Surgical Procedures / Q000379:methods; D016896:Treatment Outcome