Meningocele Repair

Diagnosis/Preparation

If an individual has spina bifida occulta, with no outward signs of a neural tube defect and no symptoms, the condition may go undetected. The protruding sacs associated with meningocele and myelomeningocele are quite noticeable at birth. To understand the extent of the defect x rays, ultrasound, computed tomography (CT) scans, or magnetic resonance imaging (MRI) of the spine may be taken.

Spina bifida may be diagnosed while the mother is still pregnant, through prenatal screening. If spina bifida is indicated, a blood test will show an elevated alpha fetoprotein. However, elevated levels can be present without spina bifida, so further testing should be done if the test is positive. There is an elevated alpha fetoprotein level in about 85% of women with a fetus with spina bifida. An ultrasound can reliable reveal the spinal structure of the fetus. An amniocentesis may be done to check for chromosomal abnormalities. In amniocentesis, a long syringe is used to draw amniotic fluid out from the uterus through the mother's abdomen. Because the protruding sac of the meningocele and myelomeningocele can look the same on the outside, it is important to have a clear diagnosis, as the anticipated outcome of the two conditions is very different.

Aftercare

The infant will first spend some time in the recovery room, and then be transferred to an intensive care unit. The infant will be monitored for signs of excess bleeding and infection. Temperature will be closely monitored. Antibiotics will be given to decrease the risk of infection, and the infant will be positioned to lie flat on the stomach to avoid pressure on the surgical wound. Extreme care is taken to keep the wound clean of urine and stool.

Risks

Surgical risks include infection and bleeding. Anesthesia risks include a reaction to the medications used, including difficulty breathing. During meningocele and myelomeningocele repair, there are additional risks of damage to the spinal column and infection of the spinal fluid surrounding the spine and brain. Damage to the neural tissue could result in paralysis, or loss of nerve function (for example, loss of bowel and bladder control). There may also be an increased risk of an urinary tract infection. An infection of the meninges is called meningitis. However, further damage would be expected if surgery were not done, and serious infection would be likely. As in all surgery, one must weigh the potential risks against the expected benefits.

Content licensed from:

Author Info: Esther Csapo Rastegari R.N., B.S.N., Ed.M., The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Surgery, 2004

This feature is for informational purposes only and should not be used to replace the care and information received from your healthcare provider. Please consult a healthcare professional with any health concerns you may have.