Myelomeningocele: the evolution of care over the last 50 years

Childs Nerv Syst. 2023 Oct;39(10):2829-2845. doi: 10.1007/s00381-023-06057-1. Epub 2023 Jul 7.

Abstract

Purpose: Myelomeningocele (MMC) is one of the representative anomalies in the field of pediatric neurosurgery. During the 50 years of ISPN history, MMC had a tremendous changes in its incidence, clinical management and outcome with advanced understanding of its pathogenesis. We reviewed the changes in MMC during the period.

Methods: We reviewed the literature review and collected our experiences.

Results: During the 50 years, major changes happened in many aspects of MMC including incidence, pathoembryogenesis, folate deficiency, prevention, prenatal diagnosis, mode of delivery, treatment policy with ethical considerations, clinical treatment including fetal surgery, latex allergy, retethering, management outcome, multidisciplinary team approach, and socioeconomic and family issues.

Conclusions: There was a great advance in the management and research of MMC during the 50 years. It is a monumental achievement of pediatric neurosurgeons and colleagues of the related fields.

Keywords: Diagnosis; Fetal surgery; Management; Myelomeningocele; Outcome; Pathogenesis.

Publication types

  • Review

MeSH terms

  • Child
  • Female
  • Fetal Therapies*
  • Humans
  • Meningomyelocele* / diagnosis
  • Meningomyelocele* / surgery
  • Neurosurgeons
  • Neurosurgical Procedures
  • Pregnancy
  • Prenatal Diagnosis