title: [How I do it: neural tube defects in guatemala - myelomeningocele spina bifida unit].
abstract: In Guatemala about 786 children are born each year with Neural Tube Defects. At our unit we operate 65 to 70 children with myelomeningocele. We have a multidisciplinary team. We recommend delivery through cesarean section. Preoperative infection is our major problem. Delayed referral is common. Dissection of placode is standard. Suture the edges of placode to resemble shape of normal cord. We perform corpectomy in cases of severe kyphosis. Hydrocephalus: We shunt 80% of the patients. Chiari II: We operate based on symptoms, first we make sure that the shunt is working, then cervical decompression. Tethered cord: We operate if observe that symptoms are progressing.
authors.affiliation: Hospital San Juan de Dios, Spina Bifida Unit, Guatemala, Republic of Guatemala.
authors.forename: Graciela
authors.initials: G
authors.lastname: Manucci
authors.affiliation: Hospital San Juan de Dios, Spina Bifida Unit, Guatemala, Republic of Guatemala.
authors.forename: Enzo
authors.initials: E
authors.lastname: von Quednow