Determining Hydrocephalus and V-P Shunt Requirements After Repair of Myelomeningocele and Myeloschisis Defects in Infants

Abstract

Abstract Aim Myelomeningocele (MM) and Myeloschisis (MS) are important developmental defects requiring surgical treatment. Although there are defined differences between both lesions, the treatment and follow-up processes are the same. Hydrocephalus has an important place among the complications that may develop after surgical closure of the defect.Purpose Analysis of factors that may determine the need for shunting in the postoperative period in patients with MM and MS defectsMethod A retrospective analysis of 100 patients (60 females and 40 males) who were treated for MM and MS between the years 2013 to 2023 at our institution was conducted. The infants were divided into two groups: Group 1; those who underwent V-P shunt surgery following MM or MS repair surgeries (n = 81) and Group 2; those who did not receive V-P shunt surgery following MM or MS repair (n = 19). Parameters such as head circumference, MM sac integrity, MM sac size, MM sac location, and birth weight were examined. The results were analyzed to identify any potential differences between the two groups.Results We included 100 patients with myelomeningocele (MM, n = 86) or myeloschisis (MS, n = 14) abnormalies in this study. The rate of V-P shunt insertion was significantly higher in infants with preoperative hydrocephalus, those with an open myelomeningocele sac structure and those with abnormalies in the thoracic/thoracolumbar region.Conclusion In infants born with myelomeningocele or myeloschisis, determining the development of hydrocephalus and the need for V-P shunt placement after the repair of the defect is crucial. This evaluation helps in planning the management of these patients, aiming to minimize complications and to improve the overall prognosis.