In the light of current knowledge, meningoceles are a congenital disorder. The skin, the posterior elements of the bony canal surrounding the subcutaneous spinal cord and the dura membrane surrounding the spinal cord remain open, and the nerve roots that go to the structures related to leg-foot movements and making and holding urine and stool are damaged as a result of contact with the external environment. Disorder of closure of the spinal cord is often accompanied by posterior brain anomalies and cerebrospinal fluid circulation disorder called hydrocephalus. Approximately 80% of the patients require shunt or endoscopic surgeries for the cerebrospinal fluid circulation, and correction surgeries may be necessary in the child’s later life. In addition, closure disorders of the spinal cord can be accompanied by abnormalities related to the foot and internal organs, and the patient may need to have operations related to these structures.
What can happen if the attempt is not made?
The pouch may burst; If it has already burst, as a result of the contact of the cerebrospinal fluid with the external environment, the patient may worsen as a result of meningitis and the disorders caused by it.
What kind of treatment/intervention will be applied:
The aim of the operation is to close the damaged area and prevent the risk of the patient’s meningitis. It is not possible to heal damaged nerves in this surgery with today’s technology. There are widespread studies in the world on the improvement of spinal cord and nerve damage (neurogenesis studies, progenitor cell studies, stem cell studies). There are no proven evidence-based stem cell results in humans yet, so one should not fall into the trap of health exploiters in this regard. Nerves are protected and a sheath is created to put them where they need to be. After the general anesthesia is given, the patients are operated in the prone position under the microscope. Appropriate skin incision is made and the dura mater membrane surrounding the spinal cord has a solid place and is exposed all around. Nerve roots attached to the wall of the sac are separated from the wall of the sac by using microsurgical technique and necessary equipment without harming the patient. Pathological examination is performed during surgery when necessary. If necessary, the tissue gap in the skin formed by the removal of the incision is closed by the plastic surgery department by sliding the patient’s own skin over the wound from his back or by using similar techniques.
Side effects that may occur:
CSF leakage from the wound (may require repair surgery).
There may be inflammation in the surgical site. This infection can lead to meningitis.
Bleeding is rare.
Postoperatively, previously unseen hydrocephalus may occur and surgical intervention may be required.
