Cervical Meningomyelocele - Single Center Experience


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AKYOL M. E., ARABACI O.

Van Tıp Dergisi, vol.30, no.1, pp.72-77, 2023 (Peer-Reviewed Journal) identifier

  • Publication Type: Article / Article
  • Volume: 30 Issue: 1
  • Publication Date: 2023
  • Doi Number: 10.5505/vtd.2023.42223
  • Journal Name: Van Tıp Dergisi
  • Journal Indexes: TR DİZİN (ULAKBİM)
  • Page Numbers: pp.72-77
  • Van Yüzüncü Yıl University Affiliated: Yes

Abstract

Introduction: Cervical meningomyelocele (MMC) is rarely seen compared to lumbosacral and thoracolumbar meningomyelocele. There are only a few series related to cervical MMC in the literature. This study presents one of the most extensive series of cervical meningomyelocele, reviewing its clinical features, surgical management, and management strategies. Materials and Methods: A total of 520 spina bifida patients, 25 of whom were diagnosed with cervical meningomyelocele, from January 2010 to September 2022, were included in the study. Results: 88% (22) of the patients included in the study were newborns. The mean age was 3 days. Of the patients, 52% (13) were female and 48% (12) were male. The most common sites of cervical meningomyelocele were C4-C5, C5-C6, and C7-T1 regions with similar rates of 24%. There was a cranial anomaly in 56% (14) of the patients. The most common cranial anomalies were Chiari II with 24% (6), hydrocephalus, and Chiari type II with hydrocephalus and syringomyelia with 16%. All patients underwent surgical resection of the sac and intradural exploration. Conclusion: Cervical meningomyelocele is structurally and clinically different from thoracolumbar and lumbosacral meningomyelocele and has more favorable outcomes after surgery. Preoperative magnetic resonance imaging and detailed patient evaluation are recommended to identify the cervical meningomyelocele's sac and spinal cord structure and additional anomalies. Surgical treatment should be done early and intradural exploration is recommended in addition to resection of the sac.