原创力文档congenital myelomeningocele - do we have to change our management先天性脊髓脊膜突出,我们必须改变我们的管理.pdfVIP
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congenital myelomeningocele - do we have to change our management先天性脊髓脊膜突出,我们必须改变我们的管理
Mayer et al. Cerebrospinal Fluid Research 2010, 7:17 CEREBROSPINAL FLUID RESEARCH
/content/7/1/17
RESEARCH Open Access
Congenital myelomeningocele - do we have to
change our management?
*
Steffi Mayer, Margit Weisser, Holger Till, Gerd Gräfe, Christian Geyer
Abstract
Background: Eagerly awaiting the results of the Management of Myelomeningocele Study (MOMS) and with an
increasing interest in setting up intrauterine myelomeningocele repair (IUMR), the optimal management of patients
suffering from congenital myelomeningocele (MMC) has become a matter of debate again. We performed a cross-
sectional study at our referral-center for MMC to determine the outcome for our expectantly managed patients.
Materials and methods: A computed chart review at our institution revealed 70 patients suffering from MMC.
Forty-three patients were eligible for the study and analyzed further. A retrospective analysis was performed only in
patients that underwent MMC repair within the first two days of life and were seen at our outpatient clinic
between 2008 and 2009 for a regular multidisciplinary follow-up. Data were collected on: gestational age (GA) and
weight at birth, age at shunt placement and shunt status after the first year of life, radiological evidence for
Arnold-Chiari malformation (ACM) and tethered cord (TC), need for surgery for TC, bladder function, lower leg
function and educational level. Data were compared to published results for IUMR and to studies of historical
controls.
Results: Patients were born with MMC between 1979 and 2009 and are now 13.3 ± 8.9 (mean ± SD) years of age.
At birth, mean GA was 37.8 ± 2.3 weeks and mean weight was 2921.3 ± 760.3 g, both significantly higher t
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