Primary myelomeningocele closure and consequences.

PURPOSE OF REVIEW: Myelomeningocele, the most frequently occurring open neural tube defect, requires lifelong care of the patient by medical professionals and by relatives. A basic understanding of the neurosurgical measures that have to be taken in the newborn, the infant, the child and the adult is important also for physicians of other disciplines involved in the treatment of patients with myelomeningocele.

RECENT FINDINGS: The most recent topic broadly discussed in this context is the role of foetal neurosurgery for closure of the neural tube defect. There is ongoing debate as to whether the beneficial postnatal effects of a prenatal operation in the unborn foetus outweighs the possible complications for the mother as well as the child.

SUMMARY: As some of the problems associated with myelomeningocele occur only later in life, it will still take many years until the beneficial, as well as the adverse, effects of prenatal neurosurgical procedures can be evaluated.